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Duke University Energy Week Part 2: The Energy Innovation Showcase

Organized by students with support from the Duke University Energy Initiative and the Center for Energy, Development, and the Global Environment (EDGE) at The Fuqua School of Business, Duke University Energy Week brought together business and technology leaders within the energy industry to provide audience members insight into the industry’s future. The focal point of this article will be the Energy Innovation Showcase, which occurred on November 11. If you want a glimpse into the eight hours of energy-focused conversation that happened on November 10, my colleague at the Duke Research Blog, Vibhav Nandagiri (Class of 2025), wrote a fascinating piece on the Energy Conference.

Welcome to the Energy Innovation Showcase (photo by Jacob Hervey)

The evening kicked off with a riveting conversation between Ajulo E. Othow, Esq. (Founder & CEO of EnerWealth Solutions and General Counsel at Carolina Solar Services) and Marshall Cherry (Chief Operating Officer at Roanoke Electric Cooperative), moderated by Duke’s own Dr. Brian Murray (Director of the Duke Energy Initiative and Nicholas Institute for Environmental Policy Solutions). Othow, Cherry, and Murray discussed the future of energy in North Carolina, from exciting prospects for renewable energy to access barriers in rural regions.

Othow, Cherry, and Murray in conversation (photo by Jacob Hervey)

At the conclusion of the keynote discussion, the evening segued into the tabling session, and the audience was released back into the Hub for two hours of mingling with energy representatives. There were spokespeople from every facet of the industry – development companies like Susteon and Good Solar, suppliers like Leyline Renewable Capital and Piedmont Lithium, and advocacy groups like the NC Sustainable Energy Association and the NC Business Council.

Grace Fernandez, Nicholas MEM/MBA student and co-chair of Energy Week, had her concerns about the whole affair at first. It was the first year that Energy Week was conducted through a hybrid of platforms, after being entirely online last year due to the pandemic. Fernandez said that it was hard to convince people – both Duke students and energy representatives – to come, but through determined calls and emails and targeted social media ads, Fernandez succeeded in her goal of getting a “new audience engaged in energy.”

Turns out, Fernandez had no need to worry about turnout. Some of the attendees included Joy and Tenzin (both Trinity ’22), who were not first-timers at the showcase; they came to enjoy the “interactive” aspect for another year and meet new people who had first-hand experience in the energy industry. Nicholas MEM student Anat is not necessarily studying energy, but still came for the “innovative” aspect – to see how new developments in energy might be more interdisciplinary and interconnected.

The attendees I spoke to took note of the fact that all the organizations present came from around North Carolina. Some, like Nicholas MEM student Chayan, would have preferred representation from further away. But others, like Pratt first-year Jack, from the Durham area, came to the showcase specifically to see what local energy companies are up to and what opportunities they may be offering.

Discussing Carolina Solar (photo by Jacob Hervey)

The spotlight on North Carolina was by design: the organizers of Energy Week had taken a different approach to this year’s showcase, specifically seeking to highlight groups from Durham and North Carolina at large. “I wanted Duke students to be able to see the incredible work happening in our own backyard,” said Trey Signorelli, an Energy Week Showcase co-chair. He commented that many Duke students aim to leave North Carolina and take their talents with them, so he wanted to put on display the many exciting opportunities they already had right on their doorstep.

Duke University Energy Week 2021 coincided with the final few days of the COP26 Climate Summit in Glasgow, Scotland. Three thousand miles away, world leaders debated coal usage and policy financing and the future of climate action. But if Thursday’s showcase taught us anything, it’s that if we want to see the future of energy, we don’t have too look far.

Post by Nhu Bui, class of 2024

What Happens When You Give People Money?

What happens when you give people money? Dr. Aisha Nyandoro and Natalie Foster know: through their research, they’ve seen the impacts of guaranteed income firsthand.

On November 9, as part of the Duke Center for Child and Family Policy’s Sulzberger Distinguished Lecture series, these experts discussed their work and what we can learn from it at “What Happens When You Give People Money: The Future of Economic Security for Children and Families.”

Natalie Foster

Foster, co-founder and co-chair of the Economic Security Project, began with the big idea of guaranteed income. Before the pandemic, wealth and income inequality were at all-time highs — disparities that “can be traced back to the origins of racialized capitalism.” But recently, things have gotten even harder. Wages have remained stagnant despite increases in productivity — and despite inflation, making it harder to afford things like rent. Foster denounced the “strong ideology that says that lack of security in this system is a personal failing. That if you can’t pull yourself up, there’s something wrong with you.” There’s something wrong with the system, Foster said. “People are working. The economy isn’t.”

Foster explained that the 1996 “Personal Responsibility and Work Opportunity Reconciliation Act” fundamentally changed welfare by converting the old New Deal-era unlimited grant program into the flat-funded block grant we now know as TANF, leaving determination of eligibility to state discretion and generally “making welfare more punitive.” The Act, Foster said, was built on racist stereotypes, like that of the welfare queen. To make matters worse, it was passed against the backdrop of a persistent devaluation of the labor of people of color

Foster said that even though there didn’t appear to be room in these political conditions to do things differently, she had the “audacity to imagine something else: the ‘adjacent possible.’” She wanted to give cash to people directly, ensuring an income floor regardless of whatever crises that may abound.

Foster worked with the mayor of Stockton, California on the Stockton Economic Empowerment Demonstration (SEED), which provided 125 Stockton residents with $500 monthly payments for two years. 

Dr. Aisha Nyandoro

Foster was connected by a mutual friend to Nyandoro, the CEO of Springboard to Opportunities. Nyandoro had launched The Magnolia Mother’s Trust, which provides low-income Black mothers in Jackson, Mississippi with $1,000 monthly payments for one year. 

With The Magnolia Mother’s Trust, Nyandoro sought to shift away from economic policy “rooted in ‘what is,’ and toward ‘what could be.’” This concept has a rich history, she said, and includes the work of Martin Luther King Jr. and the Black Panthers. She had a specific ‘what if’ in mind: “What if when Black women told us what they needed, we believed them?” What if we sought to overturn the very structures that keep these people down, and subverted the “paternalistic nature of the social safety net”? 

Nyandoro stated that as a researcher, when she has questions, she “goes back to the people.” When she did, she found that although people’s needs were individual, “cash was ubiquitous” — cash was a solution that could address every single one of the problems that she heard. Giving cash directly could help combat a system that “penalizes people for being poor, rather than trying to lift them out of poverty.” 

Why low-income Black mothers? Nyandoro explained that in order to do the work of economic liberation, one must identify what’s wrong with the system. In this case, that meant identifying those who are the most negatively impacted by the system, and using what limited resources are available to help them specifically.

Nyandoro turned to her findings: giving people cash works. These mothers are often working tirelessly, holding down two or three jobs and struggling to make ends meet. After receiving the money, people continue to work and often do so at higher rates (a major fear of opponents of guaranteed income). As a result, their income is often doubled — with life-changing results

Beyond the numbers, Nyandoro emphasized that “we are seeing joy. We don’t talk about joy enough as it relates to Black women.” This money allowed Black women to feel free, to be entrepreneurial: to “dare to dream for the first time — for themselves and for their families.” 

She referenced Chimamanda Ngozi Adichie’s famous speech “The Danger of a Single Story,” explaining that in order to change the narrative, “we need to change the narrator.” It’s time to think about whose voices we center.

In Jackson, Mississippi and Stockton, California, the pair had carried out research about the ‘adjacent possible.’ They’d used cities and states as “laboratories in democracy.” Foster said that their work was paving the way for gradual advances in guaranteed income — slowly, but surely. Then, the pandemic hit.

Suddenly, ideas that had recently been dismissed as too radical were viewed as necessary. Often unable to work, people needed money fast in order to put food on the table and cover their most urgent needs. The federal government rose to the challenge with the American Rescue Plan, providing stimulus checks and pandemic unemployment insurance, plus expanding the Child Tax Credit. “The ‘adjacent possible’”, Foster said, “had become the possible.”

The country saw an “immediate drop in poverty.” The pandemic was revealing, said Foster. It revealed that cash provides time, stress reduction, and resilience. It revealed that cash serves as a tool to create economic security and “build back better.” Above all, it revealed that “poverty is a policy choice that we’re currently making. We could make a different policy choice in order to eliminate it.”

The pandemic also revealed that stimulus checks and the Child Tax Credit were “very popular policies.” Nyandoro has observed support in the form of petitions for monthly cash transfers, the founding of organizations like Mayors for a Guaranteed Income and Guaranteed Income Community of Practice, and the launch of over a hundred guaranteed income pilots of some sort. All these efforts, Nyandoro said, are pushing toward “the same North Star”: centering the needs of families and achieving economic liberation through federal policy.

Foster turned the discussion toward next steps: “these victories have been immense, but could disappear” if the Build Back Better Act does not pass. The Act includes a year-long extension of the expanded Child Tax Credit, a key instantiation of guaranteed income. The Child Tax Credit has bipartisan support

If the extension of the Child Tax Credit passes, then according to Foster, guaranteed income is one step closer to becoming a cornerstone of social policy. This would be a “nail in the coffin of the way we’ve done policy for the last fifty years — that you’re only worth what you do in the world. Every human has dignity and worth, and we have the opportunity to build a policy that says just that.” 

Nyandoro agreed with Foster. As an anti-poverty advocate, she believes in a world without poverty: a world where “everyone can have a life of dignity for themselves and their families.” She believes that the ‘adjacent possible’ is achievable if “we can move beyond our own individual needs in order to view life as a collective, where prosperity is shared rather than hoarded.” She ended by quoting Toni Morrison: “if you have some power, then your job is to empower someone else.”

Last Friday, the House voted to pass the Build Back Better Act, which now heads to the Senate.

Post by Zella Hanson

Building a Just Foundation for Our Energy Transition

Swine Country Documentary Project

As conversations about the energy transition away from fossil fuels become increasingly important (and time-sensitive), some experts in environmental policy aren’t just worried about the conversations themselves. They’re worried about who has a seat at the table — and who doesn’t. 

Sherri White-Williams

On November 8, at “Building a Just Foundation for Our Energy Transition,” a few of these experts — Sherri White-Williamson, Environmental Justice Policy Director at the NC Conservation Network; Josh McClenney, the North Carolina Field Coordinator at Appalachian Voices; and J. Spenser Darden, the Assistant Dean for Diversity and Inclusion at Duke’s Sanford School of Public Policy — spoke about this and other issues. Thomas Klug, a Research Associate at the Duke Energy Access Project, moderated the panel, which was put together by the Sanford Energy & Environment Club.

Klug asked the panelists to define what a “just transition” really means in the context of the panelists’ work, and whether it differs from a diverse and inclusive transition.

J. Spenser Darden

McClenney answered that a just transition entails recognizing that Black, brown, and indigenous communities, as well as low socio-economic status individuals, have historically faced the worst effects of fossil fuel economies. Living in the “physical and economic traction zones,” they’re the ones that lose jobs — like coal miners, in the case of McClenney’s work with Appalachian Voices. 

However, where a diverse and inclusive transition involves “getting people to the table,” just policies will actually reflect the conversations had at the table. An unjust transition, McClenney said, is one where “people clap themselves on the back for doing such a great job having these diverse, inclusive discussions — then make policies that work against their participants.” Ensuring inclusion for communities that have historically been excluded is important, but it’s equally important to make sure the resulting policies are actually inclusive.

Josh McClenney

White-Williams agreed with McClenney — inclusion should never end at “checking the box.” The goal should be to incorporate the input of marginalized voices into resulting policy. White-Williams also added that fairness, while not necessarily guaranteed by diversity and inclusivity, is a key part of a just energy transition. 

Spenser stressed the need to move away from “extractive, colonial” ways of thinking about energy and who makes up society, and to instead incorporate indigenous ways of thinking. He stated that diversity and inclusion is reactive: people realize flaws in the way they’ve built something and try to address it later by incorporating new elements. A just system, on the other hand, is built to be “for and by” communities that have been excluded from the very start.

Klug asked the panelists to recount some of the ways they’ve seen organizations, utilities, and decision makers putting the processes required for a just transition into practice.

McClenney spoke of revelations from the onset of COVID-19 in March 2020. Preventing utility shutoffs became critically important: people were losing jobs or forced to stay at home. They couldn’t come up with the money to pay their utility bills. While fighting utility shutoffs with Appalachian Voices, he saw a group of Knoxville organizations, including Knoxville Water and Energy for All, bringing attention to the fact that the shutoffs were not just a COVID problem. For some Black and brown communities, McClenney said, “keeping the lights on had always been an issue.” These grassroot groups’ advocacy expanded beyond the pandemic: they wanted energy and water recognized as human rights.

Klug asked the panelists how they feel about President Joe Biden’s performance with regard to just transitions in the energy sector — specifically, his January executive orders and recent bipartisan $1.2 trillion infrastructure bill

White-Williams cited a major concern with Biden’s policies: they don’t give enough attention to rural issues. In Sampson county here in North Carolina, massive hog farms overwhelmingly surround communities of color. North Carolina’s new Farm Act will allow Smithfield Foods to build a system to trap methane from hog waste to be processed and eventually used as renewable electricity. But residents living near hog farms already experience toxic water, unbearable stench, and heightened risk of other diseases, and this system would likely make the problem even worse. It’s a textbook example of an unjust energy transition. That’s why environmental and civil rights organizations have asked the EPA to intervene — to no avail, at least thus far. (White-Williams is featured in this article about the current state of affairs.) “Rural America is suffering,” White-Williams said. She wants to see federal agencies using their power to ensure a just energy transition.

McClenney echoed White-Williams’ concern about hog farms, adding that deaths have resulted from providing workers with limited information about the conditions they would be working in — especially those who don’t speak English and whose undocumented status puts them in a vulnerable position. 

On a different note, he thinks Biden’s expansions to Broadband and clean water are a step in the right direction. He stated that with North Carolina’s House Bill 951, which requires the Utilities Commission to cut emissions by 70% by 2030 (even more ambitious than Biden’s executive order, which seeks to cut US emissions in half by 2030), “there are opportunities right now to effect positive change — we just have to do a good job.” It’s about how we get to that carbon reduction goal.

Klug asked how people at universities — faculty, students, and staff alike — can contribute to this work in policy and in advocacy.

White-Williams told the audience to recognize that “having a degree does not make you an expert when you walk into these communities.” Community members have lived experience: they can tell policymakers and activists what they need, not the other way around. Change should be a partnership, and so should research: “Academics have a research question before they’ve even spoken to anyone.” Instead, “listen and learn from the people who have been there all their lives.”

Spenser invited the audience to think about “who the real experts are” in unique and different ways. Institutions like Duke are often separate from the communities they inhabit, serving as a sort of beacon on the hill. “We need to invert this paradigm,” he said.

McClenney added to Spenser’s criticism of schools like Duke, who “throw food out every day and hold dorm rooms empty during the summer while people go hungry and unhoused.” What’s needed is a fundamental reimagination of the university’s relationship to the community it inhabits. He also added to White-Williams’ point about research: it can be merely “another type of extraction” if not carried out in a just manner.

Klug asked the panelists whether we need to assess the impacts of energy policy differently through the lens of research.

McClenney flagged the words “affordability” and “reliability” in energy research, asking the audience to consider who that applies to. Affordability is not just about how rates compare to New York City or California, but whether someone has to forego insulin or go hungry in order to make a payment. By thinking through these words and what they really mean, we can “begin to understand impacts on a deeper level.”

Spenser implored researchers to use an intersectional lens: instead of considering economic impact and efficiency in isolation, to consider the way in which policies “contribute or ameliorate historic disparities.” In order to truly measure impact, efficacy, and outcome, researchers must be “historically aware and community invested.”

White-Williams agreed with McClenney and Spenser, asking researchers to consider whether policies are a “band-aid or a true fix.” She cited North Carolina’s Weatherization Assistance Program, which allocates tens of millions of dollars toward fixing “patched-up” homes that may have serious underlying problems. She wonders whether it may be better to simply spend the money on programs to place people in housing that is “actually livable.”

Klug opened the panel to questions. One audience member asked the panelists what concrete steps they recommend in order to “harness the power of diversity.”

White-Williams reiterated the importance of working with impacted communities, stressing the need for local leaders who can serve as experts on the needs of the community. Elected officials might “sacrifice the needs of these communities for some other interest,” but local advocates can apply pressure where needed.

Spenser pushed back on the question, stating that instead of urgency and speed, “we need to commit to a longer process” — honoring historical legacies and “spending time helping people understand what the conversation is.” 

“Environmental policy isn’t sexy,” Spenser concluded. (“Except,” he added, “for pipelines.”)

Maybe not. But it’s important that it gets made — and that it gets made justly.

Post by Zella Hanson

“News for the Rich, White, and Blue”: Nikki Usher on her new book and the state of American journalism

Erik Carter

News organizations are facing an economic crisis

In their battle for survival, they are “realigning their priorities in ways that favor audiences who are willing to pay.” And those who are willing to pay tend to be rich, white, and politically blue.

On November 3, as part of the DeWitt Wallace Center’s Fall 2021 Information Inequalities Speaker Series, author and University of Illinois associate professor Nikki Usher discussed her new book News for the Rich, White, and Blue: How Place and Power Distort American Journalism.

Usher began by explaining that as newspapers face “market failure,” only non-geographical news is in a position to survive. As news becomes a private good (The Washington Post, The Atlantic, and The New York Times come to mind), the result is inconsistent and unequal access to news. 

According to Usher, 1800 local communities lack any regular access to local news. Usher stated that political consequences result when news organizations pull back from places that don’t exhibit that aforementioned willingness to pay. 

She gave an example of one such consequence: many journalists had their “heads in the sand” about the rising tides of populism in rural America. As a result, they were blindsided when Trump won the election. But the win simply revealed what had been the case all along. 

The New York Times editor Dean Baquet acknowledged this after the election: “We’ve got to do a much better job of being on the road, out in the country… and remind ourselves that New York is not the real world.”

Usher said that another consequence of the delocalization of news is reduced trust: only 11% of Republicans say they trust the media a great deal or a fair amount. Additionally, when places lose news, they grow more polarized, with reductions in split-ticket voting. 

Usher said that she practices a kind of “gestalt scholarship,” employing the tools of ethnography and lived experience as well as quantitative data. She dipped into this side of her research, recounting a few anecdotes which represent the “materiality” of the loss of local news.

In 2018, the LA Times moved from its Downtown home, near Skid Row, to El Segundo. The move was not without controversy. In a 2018 editorial, an anonymous author wrote that “location matters, on both a physical and symbolic level, and… moving the headquarters far away from the local power base and the most important entities and stories the Times covers… is the wrong choice.” 

The Miami Herald’s old home got demolished in 2015. Now the newsroom is near the airport, across from a cow pasture. “It’s bad for the psyche for there to be no building to exist for people to see every day,” said an editor. (A recent bit of unnerving news regarding the future of the Herald and journalism at large.)

Usher then stated that newsrooms are “places of power” that are becoming “increasingly inhospitable places for those who are non-white and who lack financial resources.” 

In June 2020, The Philadelphia Inquirer’s top editor resigned after the publication of an article with the headline “Buildings Matter, Too,” led to a walkout by dozens of staff members. At the LA Times, Latinx journalists penned an open letter drawing attention to the fact that its 13% Latinx newsroom does not reflect its nearly 50% Latinx community. In Detroit, the disparity is even worse: an 80% Black population is served by a newsroom that is only 14% Black. 

In 1968, the Kerner Commission put down a series of recommendations to improve diversity, noting that the journalistic profession was “shockingly backward” in its absence of Black journalists. The American Society of News Editors set a target date for newsrooms to be at parity with the populations they represented: 2000. They’ve since pushed the deadline to 2025. 

It’s not looking good. That’s because, according to Usher, newsrooms aren’t hiring, and “when newsrooms don’t hire, they don’t hire minority journalists.”

Usher also touched on the “death of the working class reporter.” Increasingly, the only young people who are not deterred by journalism’s instability and lack of lucrativity are those who come from copious amounts of privilege. Add this to the inability of poorer students to pursue resume-building journalism activities alongside work-study jobs, and the preference of news outlets for the oft-wealthy students of elite universities, and one can see why “journalism is becoming a profession for the elite.” 

Usher said that when “newsrooms become bastions of privilege, [that’s] bad news.” Losing journalists who come from blue-collar backgrounds means losing the ability to “empathize” with a whole set of experiences.

Usher said that as news revenue goes increasingly digital, reliance on those willing to pay is even more pronounced, with “consequences for equity in access and geographically specific news coverage.” She referenced The New York Times, whose rise “mirrors the rise in inequality” of access to news. “They know they’re leaving people behind,” Usher said. She quoted Dean Baquet, who acknowledged that 98% of Americans “were now excluded from The New York Times’ journalism and might well have to do with substandard information.”

Usher also discussed “Goldilock newspapers” — not too big, not too small, but just right for survival according to the “upside-down logic” of digital advertising. The problem is that, as Mike Wilson of the Dallas Morning News put it, “the pursuit of digital subscriptions has honed our focus on what we’re covering” — sometimes to the detriment of local readers. As a result of this phenomenon, Usher has seen reduced coverage in places considered too low-income to get advertisers. In one instance, she saw a dismissal of concerns about ad- and malware clunking up the computers of those with inferior Internet access because “those people are less likely to subscribe anyway.” 

Where does this leave us? Usher identified a few potential solutions. She reiterated calls for more inclusive newsrooms, and added her own call for higher-ed financial aid reform so that lower-income students can have a fighting chance at pursuing journalism. She discussed the need for a “post newspaper consciousness” — to acknowledge that we cannot save the newspaper, but we can identify what journalism does best and save those “special parts.” 

She left the audience with a final recommendation: journalism should “embrace the partisan media system.” Usher clarified her position: the news media like The New York Times “hides behind a veil of neutrality,” when this is only an (unconvincing) illusion. “People want to see them advocate for social justice,” she said, and she agrees. Usher doesn’t think polarization is inherently bad “if it’s polarization toward social justice and breaking down systemic inequality.”

“There’s no use assuaging people who have given up and aren’t listening. And then you have lots of people unsubscribing because the phony neutrality was irritating them,” Usher said. For organizations like the Times, the veil of neutrality is looking like a lose-lose.

She advised them to “go for those who are still listening. And just own it.”

Post by Zella Hanson

How is Universal Healthcare Like the Waterboarding Debate?

The Duke Medical Ethics Journal (DMEJ) is an undergraduate publication started in Spring of 2020 that examines conversations around universal patient-doctor responsibility. In other words, they’re training the next generation of healthcare providers to ask big questions and make informed decisions. So, we owe them a huge thank-you in advance. 

On Sunday, October 24th, DMEJ hosted Dr. Gopal Sreenivasan to speak with current members. The event was open to the public as part of the club’s mission to promote ethical practices across all fields. Dr. Sreenivasan is a moral philosopher, but he is also a professor of medicine at Duke Medical School. His position as the “Crown Professor of Ethics at the Trent Center for Bioethics, Humanities & History of Medicine,” is part of an initiative to connect societal arts and sciences aspects of Duke University to the Medical School. 

Dr. Gopal Sreenivasan

“Today, I want to talk to you all about the human right to health,” he opened. 

Sreenivasan’s talk was focused on the question of how individual countries can provide healthcare or insure health.  “One division within the human right to health is the division between health and healthcare,” he clarified. “Another is the difference between a regular right and a human right.” 

As a philosopher, Sreenivasan took the issue of access to health and placed it on a universal scale. He addressed the social determinants of health (callback time!) as part of the solution, alongside more direct-but-still-indirect healthcare actions like vaccinations. His conclusion? We are ultimately moving away from the narrative that we have a right to healthcare and towards the narrative that we have a human right to health

“You have a right to health, but that does not necessarily mean you are going to be healthy. There are still factors that affect this which are under no one’s control. It doesn’t mean that if you don’t live to be 80 or 85 that your right has been violated. But you’re still entitled to a broader range of things than just health.”

To help illustrate this for my fellow visual learners, I’ve made a fun little visual aid. 

Sreenivasan laid out a verbal map to demonstrate the confusion policy makers face about addressing the wellbeing of their constituents. If you believe healthcare is a right, you believe the government has a different role to play than if you believe health is a right. You may expect less of them in terms of handling indirect factors like social determinants and vaccines. If you believe healthcare is a human right, you expect all governments to provide healthcare access universally. This is different from Sreenivasan’s preferred view: health is a human right. All people are entitled to all aspects of their health being addressed all the time in every way in every place. 

The word human in “human right” indicates universality the same way removing the care from “healthcare” does; they both broaden the scope. 

After that lovely philosophical grammatical discussion (Do colorless green ideas sleep furiously?) as our foundation, Sreenivasan moved on to a challenging analogy: waterboarding

“It does not belong to the nature of a right that everyone has to have it. But it does seem to belong to the nature of a human right that everyone has to have it. Take the human right to not be tortured, for example.”

Your moral view may differ on whether or not it is a human right not to be tortured. You may think the right should apply to all people, or no people, or only some people. But you also may think that the right should apply to only certain aspects of torture; maybe you think that specifically waterboarding doesn’t count.

(The debate around whether or not waterboarding counts as torture and whether or not it is prohibited under human rights legislation is one that has been around for a long time. Torture has been banned by multiple American presidents in multiple environments, but the language around waterboarding in particular is highly controversial. You can read more about the debate here.)

“It’s not that some people have a human right not to be tortured which protects them from waterboarding, and other people have a human right not to be tortured but it is somehow lesser and does not protect them from waterboarding. You can’t pick and choose the content based on the person for whom the right belongs.”

So, how is the waterboarding debate like universal healthcare?

For one, it’s a matter of exclusion. It’s a matter of moral philosophy. It’s a matter of definition. 

The question of whether there should be universal healthcare goes far beyond the question of whether healthcare is a right. 

How do we improve access? Who is at fault for rising drug prices? How is America’s healthcare system different than other countries? These questions must start with questions of definition. Who is our target audience? Who is included? Who is excluded? What is included? What is excluded? 

“It seems intuitive that human rights are all or nothing.” Sreenivasan explained. “Either everyone has them or no one has them. But then you must say that their content also has to be the same.”

Post by Olivia Ares, Class 2025

This image has an empty alt attribute; its file name is ARES_Olivia.jpg

School Segregation & Culture War: Color of Education 2021

Mary Hassdyk

Perhaps you’ve heard of the 1619 Project. A Pulitzer Prize-winning New York Times journalism project which sought to place “the consequences of slavery and the contributions of Black Americans at the very center of our national narrative,” the project has been controversial and is thought to have sparked the current debate over critical race theory in the classroom.

Its creator, Nikole Hannah-Jones, spoke at the Color of Education virtual summit on October 26. She discussed her journalistic research on systemic racial inequities in the education system, as well as the 1619 Project and the struggle over teaching race in the classroom.

Nikole Hannah-Jones

Hannah-Jones defined the public school as an “intimate place” where young members of society come together to “exchange ideas and culture, meeting across class and race.” The public school serves to create community, which, she stressed, is necessary for a healthy democracy. “A sense of community prevents polarization,” she said. “I know that a person who’s different from me still wants, fundamentally, the same things.” That gives us more of an opportunity to solve political problems without hostility. 

Instead, she often sees “segregated” low-income mostly-Black schools and “integrated” mostly-white schools, separated by a disturbing chasm of resources and opportunity. (She’s written about this in several Times pieces.) She remarked that “this bifurcation doesn’t serve our democracy and it doesn’t serve humanity.”

But that’s been a problem since before Brown v. Board of Education. What’s changed in the last few years, according to Hannah-Jones, is that in the wake of last year’s Black Lives Matter protests, there is now a “culture war” being waged over critical race theory. 

Critical race theory is an academic framework that examines the intersection of race with law and public policy. The theory is controversial: many fear the fundamental critique of the US legal and economic system that the theory ultimately implies. (In 2020, whereas white conservatives and more moderate liberals tended to blame fatal incidents of police brutality on “a few bad apples,” the viewpoint consistent with critical race theory is that “the problem is the barrel and the systems that produce it.”)

Laws banning the teaching of critical race theory have already been passed or are in the works in several states, including here in North Carolina, where Governor Roy Cooper recently vetoed a bill which sought to regulate the teaching of several race-related concepts, including whether “a meritocracy is inherently racist or sexist.”

There’s also historical revisionism, known pejoratively as ‘revisionist history’: the reinterpretation of orthodox views surrounding historical events, or, according to fellow Times contributor and historian Timothy Snyder, “the parts of history that challenge leaders’ sense of righteousness or make their supporters uncomfortable.” (Snyder says that in the US, “the ‘revisionists’ are people who write about race.”) 

Critical race theory ultimately requires some revisionism — to critically examine the intersection of race with the laws and policy of the current moment, we must critically examine how we got here, and that means taking another look at the US’ legal history, war history, even its history of infrastructure. Critical race theory is usually taught in college humanities classes. (Kimberlé Crenshaw coined the term in the 1980s, and her work is decidedly college level — I’ve read her here at Duke, but certainly not before.) But because critical race theory and revisionism are linked, it’s come to pass that any K-12 effort to teach about how racism has informed US history now gets labeled as “critical race theory” by adversaries of these efforts. 

Critical race theory has become a buzzword — and in many circles, it’s a bad word. These days, if a parent thinks you’re teaching critical race theory, you might soon find yourself without a job. (The summit required a passcode and was not recorded for fear that educators participating might be “outed as believers” in critical race theory and subsequently maligned.)

Along with educators in the Zoom comments, Hannah-Jones discussed this problem: teachers are getting accused of teaching “critical race theory”; the term is being used as a weapon and to imply wrongdoing; and it seems that parents, legislators, and even some educators don’t know what it actually means. 

Hannah-Jones asserted that this is “how propaganda works.” The term “critical race theory” is being used to produce fear and automatic condemnation, which distracts from the content of the theory and shuts down further (more rational) conversation. Hannah-Jones gave some advice to educators: “When a parent says, ‘I do not want my child to learn critical race theory,’ Ask them what they think that it is. They don’t know. And then you get to say, ‘Well, no, that’s history. Well, no, that’s anti-slavery.’ You get the point.”

Hannah-Jones explained that “as educators, you have to have these conversations with people.” Parents don’t necessarily know what their children are learning in school — and that can be a source of anxiety. So when “bad-faith actors are fear mongering, saying ‘Don’t you know what terrible things your kids are learning?’” it’s all too easy for parents to become distraught and distrust their child’s teacher.

Moving to discussing other issues in education, Hannah-Jones emphasized that schools are generationally deprived of resources, which is a problem that “can’t be fixed overnight.” She’s seen parents trying to advocate for their children and failing because they lack proximity to social, political, or legal power. “Maybe they can’t come to PTA because they’re a single mother, or they work at Popeyes — they get dismissed,” she said. “There’s no meeting with the superintendent. They can’t call the media in.” And when power dictates one’s ability to make change, the generational deprivation of resources can only continue.

Jayden Grant, a senior at Falls Lake Academy, asked Hannah-Jones how to ensure that these issues are addressed on the level of charter and private schools, which aren’t governed by the same policies. 

Hannah-Jones replied that she is fundamentally opposed to charter and private schools, viewing them as “undemocratic by design.” As such, “holding them accountable” is only possible through public advocacy, namely through the media. Students have the strongest voice, she told Jayden. They’re the reason these schools exist in the first place; it’s up to them to challenge policies or actions they see as unfair and make the public aware. 

On that note, Hannah-Jones brought the conversation back to the question of which version of our collective past will be taught in the K-12 classroom. Hannah-Jones said that based on the feedback she’s gotten and conversations she’s had, the 1619 project has inspired kids. It’s made them excited about history and learning in general. She denounced the neoliberal “privatization and commodification of education,” stating that often, parents wrongly view themselves as consumers. “We need to center kids in these discussions,” she said.

Hannah-Jones wrapped up the discussion with a call to action. She told the audience to “get angry” that authors like Ruby Bridges and Toni Morrison are being blacklisted, because “that is the same kind of thinking that’s led to the inequality we see now.” She claimed that “people wouldn’t be freaking out about the 1619 Project if it wasn’t having an effect,” but the Project is making waves, because “those who control the stories about who we are control the culture.” And the culture Hannah-Jones wants to see is one which sees the “least of us as just as deserving as anyone else.”

Professor Emeritus at UNC Harry Amana had the last word, saying that one cannot be an educator without being an optimist. That’s because, as an educator, you believe that “if people knew better, they would do better.” 

Maybe one day, we all will.

Post by Zella Hanson

Will the Humanities Save the World?

Lorenzo Gritti

The bad news about the energy transition, according to Dr. Matthew Huber, is that it’s not happening. At least, not at the scale we need it to. A June report stated that the share of fossil fuels in the world’s total energy mix is still about 80%, as it has been for several decades. “We still live in a system fueled by fossil fuels,” Huber said. 

Matthew Huber
Jennifer Wenzel

On October 18, Huber, author of Lifeblood: Oil, Freedom, and the Forces of Capital and a professor at Syracuse University, joined Dr. Imre Szeman, author of On Petrocultures: Globalization, Culture, and Energy and professor at the University of Waterloo, and Dr. Jennifer Wenzel, author of The Disposition of Nature: Environmental Crisis and World Literature and professor at Columbia University.

Moderated by Dr. Ranjana Khanna, professor and director of the John Hope Franklin Humanities Institute here at Duke, the panel discussion “What Can the Humanities Contribute to the Global Energy Transition?” explored the potential of humanities fields to help supplement perspectives offered by the sciences, teaching us about new ways of living for a greener world.

Imre Szeman

Khanna posed the titular question: what do the panelists think that the humanities have to contribute to the energy transition?

Huber responded that in dealing with climate disaster, the “critical issue of our time,” there’s a civic responsibility to engage with the “public and political struggle” for change.

Humanities scholars excel in the art of persuasion and argumentation, and they can use that in public forms, like the Op-Ed and social media. Whereas the public conversation is skewed towards economics and engineering, humanities scholars can emphasize the equally important political and cultural barriers toward the energy transition. 

Huber also called on history scholars to help recover the “deleted history” of what is politically possible.

“After four decades of neoliberalism we’ve forgotten what the public sector can actually do,” Huber said, “but when we remember the Soviet-style planned economy during World War II, and the New Deal, we recover that these large mass scale transformations have happened, and are possible,” Huber said. He also lamented that the social movements of today’s Left have become “atomized, neutralized, and largely ineffective” such that “students don’t believe in large-scale social change anymore.” With public history, activists can show how and why struggles of abolition have won in the past, and how that could be applied to the struggle for carbon abolition. 

As the Climate Critic in the Green Party of Canada’s Shadow Cabinet, Dr. Imre Szeman drafted the Green Party’s proposal for the energy transition. He says that upon seeing the recommendation to end all production of fossil fuels, journalists asked Szeman, “Is this realistic? Here? Now?” They seemed to view such a change as “impossible — even though they might want it.”

Szeman argued that whether climate solutions are considered ‘realistic’ isn’t so much a question of cost, but of “our ability to conceptualize another way of being in the world,” which is where humanities fields come into play. He then posed a series of questions, including “What do we love about our current habits and behaviors? Who is culpable for the carbon dioxide in the atmosphere? How did we get here, and what does this say about our ability to get somewhere else?” He said that the role of the humanities in the energy transition is to answer all of these questions — and to remind us of the need to ask them in the first place.

Wenzel agreed, explaining that energy humanities can help us examine the literary and cultural narratives that shape our experience. She explained that fossil fuels enable a “chain of ease” wherein the primary mode of thinking about fossil fuels in everyday life is not thinking at all. She discussed the oil inventory activity she does with her students, where they account for the ubiquitous significance of oil in their lives. We develop an “embodied attachment” to the things that oil makes possible — the smoothness of plastic, the speed of auto, the smell of a butane stove. This leads us to an “impasse: we know where we stand, but we’re unable or unwilling to take action at the scale we know we need to.” 

Wenzel explained that the oil inventory was actually invented by the oil industry with an insidious intention — to get consumers to consider the indispensability of petroleum products in their lives “to produce wonder and appreciation.” She showed the audience an Exxon commercial, in which scenes of vast, interconnected energy grids play across the screen as a soothing voice tell us, “you don’t need to think about the energy that makes our lives possible. Because we do.

Wenzel emphasized that the effect of rhetoric like Exxon’s is to “ensure passivity.” The lesson? When we take stock of the impact of oil on our lives, how we use that information matters most. Climate activists must reclaim the oil inventory to “disrupt habits of mind” rather than entrench them.

Khanna noted that one of the humanities’ core methods is a “revelatory gesture of critique,” and asked the panelists what they thought about “moving past that initial gesture, toward some broader consensus for change.” 

Wenzel said that doing the work of the oil inventory is powerful, but “not the last move.” We must make other moves, and in terms of thinking about what we might do otherwise, we must take care to be “forward thinking, but deeply, critically, historically informed.”

Huber said that we need to interrogate the “politics that attach oil to life,” because it’s a strategy of moving politics away from work, production, and who decides its conditions. Production today feels invisible — it’s offshore, outsourced — so that we fail to ask questions about who’s controlling it, and to what effect. He called upon the 1930s, when a “radical politics of production was on the table,” and said that climate-conscious humanities scholars need to work to recover this history.

Szeman had one “next move,” in the words of Wenzel: to realize that oil companies in the US are private, unlike in much of the rest of the world. “There’s a decision made very early on” about how and in what quantities oil is to be used — a decision that could be amenable to change.

Khanna opened the panel to questions. One audience member asked about how to advocate for an energy transition in light of the fact that capitalism is ultimately responsible for much of the status quo and the damage it has caused. How can humanities scholars critique the status quo without critiquing capitalism to the point of suspicion from would-be supporters?

Szeman emphasized the need for recognition that there are some things that one can do in the political sphere, and some things one can’t. Even though the Green Party falls squarely on the political left, “we don’t explicitly criticize capitalism right off the bat, because that doesn’t seem like the winning position.” It’s important to give voice to discussions about change “to the extent possible within the official political sphere.”

Wenzel told the audience about giving a talk on energy humanities at the Pipeline Safety Trust conference. She had to “stand in front of the oil industry” — regulators, landowners, executives — which meant “thinking about which values and assumptions to share.” By establishing credibility, she could “make conversations about this problem, which implicates all of us, possible” — despite their different perspectives.

Huber contended that when the enemy is as abstract as the quasi-global system of capitalism, it can “induce paralysis.” He’s “not sure we can absolish capitalism on the time scale” necessary for the energy transition. He quipped that the earth is not dying, it’s being killed, and “those who are killing it have names and addresses.” Those people are the target, he said — just as in the abolition of slavery, when the target of struggle was the slave owning class, another oligarchical power representing about 1% of the population. Although he supports a systemic critique of capitalism, right now “we need to be more concrete. These people have names and addresses,” he reiterated.

Another audience member asked about how to “break down the concepts of beauty and pleasure” that support the current oil regime.

Huber discussed the need for “low-carbon luxury” and an investment in open green space as part of any Green New Deal. Climate politics has often been about “shame, fear, guilt, sacrifice,” he said, and “we’re not going to win on that.” A beautiful, pleasurable vision of the future is what’s needed to win people over.

Wenzel identified the role of literature in “collecting and borrowing” ideas of beauty, arguing that beauty is always constructed. To those who view renewable energy, like wind and solar, as an eyesore, Wenzel posed the question: “Are oil spills ‘beautiful’?” (Take a glimpse.)

Someone asked a question about science fiction’s ability to “dream futures into being” — what should humanities scholars aspire to read and write? 

Wenzel said that there are many ways to think about the future, and that apocalyptic renditions of science fiction are essentially “practicing for possible bad futures.” Huber agreed, stating that apocalyptic visions can be galvanizing — but there must be a positive vision that wins people over (he pointed to AOC’s “Message From the Future”).

Szeman said that utopian narratives tend to say more about the viewpoint by which a fictional world is considered a utopia than a “prescriptive way to get there,” and suggested that humanities scholars interested in fiction might consider creating more of the latter.

Revolutionary ideas were discussed during the two hours, and panelists acknowledged that humanities fields can’t do all of this work alone. 

Wenzel told the audience about a discussion she had with an economist from the Energy Policy Center. She’d said, “we’re interested in the non-technological obstacles to transition and non-technological tools to foster public demand for these changes. We want to understand why people remain so attached to the world that fossil fuels have created.” The economist said, “Right. We call that demand-side management.”

The audience laughed, understanding the frustration that often results from the disparate methodologies of science and humanities fields. Wenzel said she “felt a bit deflated” — but also learned a word she could use in future collaborations with economists and policymakers. 

The humanities have many valuable contributions to the energy transition: recovering histories, disrupting the status quo, crafting new narratives. But what’s important right now is communicating this. Wenzel left us with an instruction: “We need to learn to build bridges across different disciplines.”

This event was organized by the Energy Humanities Working Group in partnership with the Duke University Energy Initiative, Nicholas Institute for Environmental Policy Solutions, and John Hope Franklin Humanities Institute. Duke students or faculty members can join the Energy Humanities Working Group by contacting Dr. Tom Cinq-Mars (tom.cinq.mars@duke.edu).

Post by Zella Hanson

Discipline Makes You Free: Exploring Nigerian Militarism in the Late 20th Century

Six years after Nigeria gained its independence from Great Britain in 1960, a bloody military coup transferred power to the nation’s armed forces.

The ensuing forty-year period was marked by eight different military regimes and a Civil War, which were often demarcated by similarly violent coups that overthrew the initial Republic. Brief interludes of constitutional republics occasionally emerged, but these periods were short-lived and quickly replaced by another military government.

The eight different Heads of State under different military governments (Top row from left to right: Aguiyi-Ironsi, Gowon, Mohammed, Obasanjo. Bottom row from left to right: Buhari, Babangida, Abacha, Abubakar).

The heads of these regimes were military strongmen, soldiers who had risen through the chain of command and sought to rule the nation with near-absolute power. Samuel Fury Childs Daly (PhD), a professor in Duke’s African and African American Studies department and author of the acclaimed book A History of the Republic of Biafra: Law, Crime, and the Nigerian Civil War, sought to dive deeper into the political philosophies of these authoritarian rulers.

Daly says the writings and opinions of these autocrats often receives insufficient attention in the modern accounts of Nigerian history. The title of his lecture through the Franklin Humanities Institute, “How Soldiers Think,” attempted to address this lack of analysis by asking several important questions: What did these soldiers believe? Why did they enact the laws that they did? How did they envision Nigeria’s future?

Dr. Samuel Fury Childs Daly (PhD)

The story of Nigerian militarism, according to Daly, has its roots in the decolonization process. The soldiers and lawmakers of the later 20th century found their inspiration in one of the most famous decolonial thinkers: Frantz Fanon. Fanon’s two seminal works – Black Skin, White Masks and The Wretched of The Earth – were rooted heavily in his experience as a trained psychiatrist and a soldier for the Front de Libération National, the Algerian nationalist movement that fought against French colonial rule during the French-Algerian War (1954-1962). His advocacy for violent decolonization inspired anticolonial fury within Nigerian intellectuals and soldiers alike, leading to the widely accepted notion that military violence could be both reparative and restorative.

Fanon, in many ways, gave these soldiers a language of revolution, but, as Daly points out, many of them found his socialist politics to be too radical for Nigerian society. To the military rulers, the ideal system of governance was ascetic, masculine, and heavily disciplined.

In many ways, these soldiers sought to craft Nigeria in their own image–an image of order and self-control, a society where civilians needed to be tamed.

To create this society, the soldiers relied heavily on criminal law and the law enforcement apparatus. To them, law served as a tool of social engineering, albeit one that didn’t always work in their favor. Despite setting up a plethora of friendly judges throughout the judicial system, occasional rulings would rub military officers the wrong way. Nonetheless, they were able to exercise their heavy influence over the legislative and judicial systems to set forth programs aimed to reduce the perceived disease of chaos that plagued the Nigerian population.

One of the major initiatives Daly highlighted was the infamous War Against Indiscipline (WAI). The WAI initiated a number of often draconian programs such as the mandate to queue in an orderly manner for buses. Those who refused to form a line would be promptly whipped or beaten by an officer. Other social reforms outside of WAI centered heavily around sacrifice and control, such as the requirements for women to dress modestly and for men to stay fit; in fact, exercise was routinely used as public punishment for unruly activity.

These behavioral and punitive measures were heavily inspired by the rigid and militaristic upbringing of these autocrats, which is precisely why they were so unpopular with civilians. Daly describes several misconceptions within these leaders’ political philosophy – their treatment of politics as binary, their desire for conformity, their misconstrued knowledge of what their people want – that ultimately led to the instability of their regimes.

Through a unique combination of warped decolonization rhetoric, militaristic attitudes, and malleable jurisprudence, Nigerian political practices of the late 20th century offer a glimpse at the shortcomings of discipline as a primary political ethos. The societies formed under the military heads of state were illiberal and, contrary to the title of this article, decidedly unfree.

*the images from this article were obtained from Dr. Daly’s 2021 presentation “How Soldiers Think” through the Franklin Humanities Institute.

Post by Vibhav Nandagiri, Class of 2025

Law Tech Demo Roundup, Using Technology to Address Gaps in Access to Justice

If innovative technology solutions are the key to addressing gaps in our justice system, Duke Law Tech Lab (DLTL) is a place where these solutions come to life.

Friday, October 22nd, three teams presented on their work, supported by DLTL, to change the way that legal services are delivered. And the presentation had more at stake than just educating the attendees. Real cash prizes were on the line – voted on by a panel of judges and even audience members – to provide even more funding for these startups.

Jeff Ward introduces the 2021 Law Tech Legal Demo Judges.

The three teams were accepted out of dozens of applications to work with the DLTL, according to host Jeff Ward (JD), Director of Duke’s Center on Law and Technology and Clinical Professor of Law. The Lab looks for early-stage companies striving to increase access to legal solutions to offer monetary support, but the missions of the DLTL initiative go far beyond that. DLTL is building a community for creative entrepreneurs in the legal tech space, connecting start-ups with valuable partners and mentors, and fostering a space of growth through tailored resources and support.

First up at the 2021 Law Tech Lab Demo Day was Creators’ Legal. “The traditional legal solutions simply don’t work for the modern content creator,” said Eric Farber, founder and CEO of Creators’ Legal. Farber’s company is seeking to help what is now the second-fastest sector of the world economy: Content creators. Content creators are people who generate revenue by sponsorships and advertising, often through social media platforms like Instagram, Facebook, or TikTok. This market is huge and expanding, but “completely underserved” with legal solutions, said Farber.

Creators’ Legal CEO and Founder, Eric Farber, explains how the company works to support modern content creators.

Because content creators can go from production to distribution within just a few hours or less, traditional entertainment legal that is filled with time-consuming, expensive, and unresponsive lawyers is not a viable option.

Farber says that “Industry Standard Agreements and deals are hidden behind the doors of [this] traditional legal.” By creating a platform that has easy-to-use contract templates, eSignatures, and a digital briefcase for storing files offered on a by-contract or subscription-basis, Creators Legal wants to be a company that serves the gaps left for content creators.

Next up was Justice Innovations, represented by its CEO, Sasha Davenport. Davenport and Justice Innovations want to rearrange the workflow associated with the process that happens from the time a crime takes place to the person who has been arrested for the case makes their initial appearance in court.

“This [at the initial appearance] is where things get really interesting for me,” said Davenport because about 40% of cases are dropped for no-actions. This leads to a huge number of wasted time, effort, budgets, and more. By creating and integrating a software system that they are dubbing Vet-IT, the company wants to increase data-sharing across agencies that should be on the same page with each other but often are not.

Sasha Davenport, CEO, explains how Vet-IT works through different steps from initial crime reporting to someone’s first appearance in court.

Through the data-sharing platform, information would be entered about a case from the first moments of crime investigation to help decide if this is a charge that would even end up being prosecuted or not. The benefits, according to Davenport, including filtering out bad cases, deflecting more people from entering the carceral system, decreasing jail populations, expediting redirection for individuals in need to mental health interventions, and, potentially, improved community-police trust. Justice Innovations were inspired to pursue this idea because of the great success that Harris County Texas has had in producing few no-action cases. Harris County achieved this by a process of phone-trees across agencies for the last 50 years.

Founder and Executive Director of SAEF Legal Aid, Eamonn Keenan, explains the company’s marketing strategy of community outreach.

Last, but not least, was SAEF Legal Aid. Eamonn Keenan, company Founder and Executive Director, laid out the team’s legal tech solution. There is a systematic problem of finding the legal support that one needs before it is too late, bringing with it immense challenges and large expenditures of time. Keenan became aware of this issue while working at a legal aid help desk. SAEF Legal Aid’s solution is to leverage practical tech to more accurately diagnose user’s legal problems and facilitate access to free or affordable legal solutions via reliable referrals and strategic partnerships.

In doing this work, the team hopes to help low-income families more immediately, starting with family law services and expanding out. A large part of their solution also includes building partnerships with “word-of-mouth marketing” to embed the service in high-need communities. “People without internet access might need legal help the most,” Keenan said. SAEF Legal Aid hopes to cut through the lack of staffing for legal aid advice desks and bypass the waiting game of larger legal aid providers who often have high turn-away rates and long waiting periods for attorney follow up to resolve the barrier that intake causes in gaining access to legal help.

At the end of the presentation, Justice Innovations walked away with the Audience Favorite prize and SAEF Legal Aid took the Grand Prize. Regardless of prizes, these three teams will inevitably continue to be part of the solution to gaps in justice as they carry their work forward.

Post by Cydney Livingston

Integrating Pediatric Care in NC: Behavioral Health Perspectives

In healthcare, developing a new treatment is often half of the battle. The other half lies in delivering these treatments to those communities who need them the most. Coordinating care delivery is the goal of NC Integrated Care for Kids (InCK), an integrated pediatric service delivery and payment platform looking to serve 100,000 kids within five counties — Alamance, Orange, Durham, Granville, and Vance — in central North Carolina. The project is a collaborative effort between Duke, UNC, and the NC Department of Health and Human Services (DHHS) funded by a federal grant from the Centers for Medicare and Medicaid Services (CMS). The program’s executive director is Dr. Charlene Wong (MD, MSPH), a Duke researcher, physician, and professor who leads an interdisciplinary team of researchers and policy experts as they explore ways to reduce costs via integrating care for North Carolina youth enrolled in Medicaid and Children’s Health Insurance Program (CHIP).

The five counties that are part of NC InCK

I recently had the opportunity to speak with two of InCK’s service partners: Dr. Gary Maslow (MD, MPH) and Chris Lea (Duke ’18). Both work within the Behavioral Health group of InCK, which seeks to use behavioral health expertise through collaborative care and training providers to help support pediatric care. Maslow, a professor at the Duke Medical School, has focused heavily on child and developmental psychiatry throughout his career. Having entered medical school with a desire to work in pediatric hematology, Maslow recalls how a conversation with a mentor steered him in the direction of behavioral health. At the time, Maslow was part of the Rural Health Scholars program at Dartmouth College; while discussing his aspirations, one of his professors asked him to consider conditions outside of cancer, leading Maslow to consider chronic illness and eventually child psychiatry. “Kids have other problems,” Maslow’s professor told him.

Dr. Gary Maslow (MD, MPH)
Chris Lea (Duke ’18)

When looking at healthcare networks, especially those in rural areas in North Carolina, Maslow noticed a disaggregated service and payment network where primary care providers were not getting the necessary education to support the behavioral health needs of children. His work with Lea, a third-year medical student at Duke, has centered around looking at Medicaid data to understand provider distribution, medication prescription, and access to therapy based one’s area of residence. Lea’s path to NC InCK began as an undergraduate at Duke, where he obtained a B.S. in psychology in 2018. As he explains, mental health has been a vested interest of his for years, a passion reinforced by coursework, research at the Durham VA Medical Center, and NC InCK. He discussed the important of appropriate crisis response, specifically how to prepare families and providers in the event of pediatric behavioral health crises such as aggression or suicidality, as critical in improving behavioral health integration. These safety plans are critical both before a potential crisis and after an actual crisis occurs.

Two main goals of Maslow and Lea’s work are to increase the implementation of safety plans for at-risk youth and expand follow-up frequency in primary care settings. The focus on primary care physicians is especially critical considering the severe shortage of mental health professionals around North Carolina.

The behavioral health group is but one subset of the larger NC InCK framework. The team is led by Chelsea Swanson (MPH). Other collaborators include Dr. Richard Chung (MD), Dan Kimberg, and Ashley Saunders. NC InCK is currently in a two-year planning period, with the program’s launch date slated for 2022.

Services provided by NC InCK

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