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#817 -- Part 1 of 2: A Systemic Approach to Occupational and Environmental Health, 12-May-2005

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#817 - Part 1 of 2: A Systemic Approach to Occupational and Environmental Health, May 12, 2005
  
By Skip Spitzer*

There are signs that public awareness about corporate impacts on society is rising.[1] A 1999 industry-sponsored global survey warned that citizens in general feel that protecting the environment and the health and safety of employees are more important corporate responsibilities than making a profit.[2] In the U.S., a 2000 Business Week/Harris poll noted with some alarm that 40% "agree" and 32% "somewhat agree" that "business has gained too much power over too many aspects of American life."[3] Likewise, there are indications that progressive movements around the world are increasingly focusing on the role of the corporation, even among liberal groups for which this is new terrain.

As the corporate role in occupational, public health and other problems receives scrutiny, it is essential to recognize that it is not sufficient to identify specific acts of malfeasance or influence, or even to campaign to address them. A more comprehensive and systemic framework for understanding the role of corporations requires consideration of corporate power and its effects as endemic features of national socio-economic systems and the rapidly integrating global order. The present contribution offers such a perspective, highlighting the need for systemic change and providing a useful picture of the "structure of harm" -- the underlying social structures (or institutional arrangements) that produce social and environmental problems, and undermine reform. It also presents implications for researchers, policy-makers, activists and others trying to address environmental and occupational health problems, particularly with regard to integrating efforts to address immediate impacts with those for longer-term, systemic change.

The need for systemic change

Many contemporary social movements are characterized by efforts to resolve particular problems as quickly as possible.[4] This is, of course, often a direct response to immediate harm or inequality, frequently life-threatening or environmentally catastrophic. It is also a reasonable approach given limited power and capacity.

Relatively near-term, issue-focused public action generally focuses on:

* Educating the public to raise awareness about an issue

* Changing consumer behavior to influence market dynamics (e.g., to eliminate a product or type of production, promote alternatives or reduce consumption generally)

* Pressuring corporations or other private actors to cease, clean up or provide compensation for a harmful practice

* Pressuring government for a socially just or environmentally sound policy or other action

* Developing alternatives (e.g., organic farms, local food systems, Community Supported Agriculture programs,[5] micro-lending, communities based on popular principles)

These responses are frequently successful, sometimes achieving extraordinary improvements in economic welfare, democratic participation, environmental safeguards, and racial, gender and other rights. Pesticide reformers, for example, have achieved bans, restrictions, stronger enforcement, worker protections, reporting systems, research on and use of alternatives, development and growth of organics, international agreements and more. The Stockholm Convention on Persistent Organic Pollutants (POPs), for example, protects human health and the environment by requiring governments to eliminate or reduce the release of certain toxic chemicals that persist in the environment, travel widely and accumulate in the fatty tissue of living organisms.[6]

Nonetheless, near-term, issue-focused reform efforts are typically frustrated (and in many cases rendered futile) by the dynamism of entrenched power, in several important ways. First, change efforts regularly face an extraordinary range of built-in hurdles in the form of governmental and corporate misinformation, legal action, surveillance, etc.; lack of funding; public apathy, ignorance and preoccupation; media bias and lack of attention; and the like.[7]

Second, even where public action is successful, at least four kinds of systemic dynamics commonly prevent fundamental change:

1. Shifts in production. Curtailing one harm often results in increases in another. For example, the banning of DDT in the U.S. led to broad adoption of chlorpyrifos.

2. Innovation. New, risk-posing technologies are continually commercialized. For instance, genetically engineered crops pose serious new problems, including: novel health risks, irreversible genetic contamination, harm to wildlife, corporate control of seeds through new intellectual property rights, biopiracy[8] and threats to organic agriculture.[9]

3. Co-optation. Alternative approaches are undermined and co-opted. For example, the extraordinary growth of the organic foods sector has led to the growing problem of "industrial organics." Through growth and acquisitions, U.S.-based Horizon Organics, for example, now controls 70% of the U.S. organic retail dairy market and is fully owned by Dean Foods, one of the top 25 food giants globally.[10,11]

4. Limited accommodation. Problems that are least challenging to the economic order may change (e.g., leaded gasoline), whereas there is little response on more threatening issues (e.g., carbon dioxide emissions).

Finally, systemic dynamics may simply overwhelm reform efforts through the amount of harm they produce. In the U.S., for example, about 85,000 chemicals are registered for use -- most with no or inadequate testing -- with 2,000-3,000 new substances registered every year.[12] The harms and risks of industrial chemicals alone are staggering, yet there is an astonishing array of other social and ecological problems: environmental wounds (like global warming,[13] ozone depletion and species extinction), small producer hardship (loss of family farms, for example), undemocratic institutions (such as money-distorted political systems and the World Trade Organization), militarism and intervention (from Iraq to Haiti), social ills (like homelessness, hunger, poverty, crime and discrimination) and violation of human and animal rights, among many other issues. Is it possible to catch up? How significant are irreparable impacts? At what point do change efforts become too little too late?

Many of those who experience these frustrations recognize that underlying causes and barriers to change must ultimately be addressed. One common reconciliation of the tension between near-term action and underlying causes is the idea that, over time, progress on specific issues will achieve systemic change. This approach is reflected, for example, in sustainable agriculture movement slogans such as "Changing the world one farm at a time." Some "green" businesses are based on this idea or have adopted it in their advertising, such as California-based Give Something Back business products, which is "Saving the world one paperclip at a time."[14] In fact multinationals and others committed to the status quo promote this idea: for example, partnering with low-income housing builder Habitat for Humanity, Dow Chemical declared that it is "changing lives one home at a time."[15] The efforts behind the "one at a time" concept are often significant. Yet incrementalism, in the sense of cumulative successes fundamentally transforming societies, ignores the actual nature of underlying social structures.

The structure of harm

What then are the underlying causes of harm that must be addressed? Many explanations of the cause of harm overlook that societies are integrated systems of institutionalized and organized patterns of behavior, values and beliefs. That is, while factors such as lack of awareness, greed, money, technology, dangerous Prime Ministers and uncaring corporations may be intermediate causes of harm, it is important to look at the functioning of a given society as a whole, or what we might call the "structure of harm."

The literature addressing the fundamental nature of modern societies and the global system is vast.[16] The intent here is not to survey this field or provide a new totalizing theory, but rather to identify basic structural features of harmful societies, drawing primarily on the case of the United States. These characteristics are somewhat generalizable to other advanced market economies of the global North, parts of the global South, and the world system. They are a good starting point for conceptualizing the structures of harm at the root of contemporary social and ecological crises.[17]

Corporations are a central aspect of social life

In 1787, fewer than 40 corporations operated in the United States.[18] As late as 1920, there were approximately 314,000.[19] In 2003, there were more than four million.[20] Corporations now account for about 74% of all U.S. production.[21] This means that the core economic decisions (what, how and how much to produce, using what resources) are largely in corporate hands. Through work and consumption, virtually everyone is profoundly affected by corporations. Corporations are also powerful social actors, affecting virtually every other aspect of social life. Corporations largely ignore social and environmental costs

Corporations are compelled to maximize profit or shareholder value or face elimination by competitors.[22] In the U.S., officers and managers who do not work to maximize shareholder value are in fact subject to legal action for violating fiduciary obligations to act in the best interest of the corporation.

Focusing first and foremost on profitability means that decisions are explicitly based on consideration of a firm's own costs and revenues, while costs and benefits to society (or "externalities") such as pollution or use of recycled materials, are largely ignored. Modern microeconomic theory specifically prescribes this: to maximize profit, individual firms should keep producing units of a product until the unit (or marginal) revenue earned is just equal to the firm's cost to produce it. Even decisions to spend on community development, charity and other "corporate responsibility" programs are generally treated as "investments" and limited to projects for which there is a "business case."[23]

Reagan Administration economist Robert Monks described it this way: "The corporation... became something of an externalizing machine, in the same way that a shark is a killing machine --no malevolence, no intentional harm, just something designed with sublime efficiency for self-preservation, which it accomplishes without any capacity to factor in the consequences to others."[24] If corporations had to take into account external costs and benefits to society, they would make radically different production decisions.[25]

Competition creates economic concentration

Competition between firms striving to maximize profit leads some corporations to get bigger than others. Through growth and expansion, mergers, acquisitions and other consolidation within and across sectors, many corporations have become extremely large and many industries are now dominated by relatively few producers. Some corporations dominate in multiple industries. For example, the top six agrochemical producers control about 65% of U.S. pesticide market[26] and four of them are leaders in transgenic seeds. Overall, just 1% of businesses control 80% of U.S. private sector production.[27]

Concentration leads to remarkable economic and social power. It also undermines the market. While bigger firms may achieve economies of scale, markets retain their self-regulating capacity only when there are many buyers and sellers (such that no one firm can influence prices), few barriers for new firms to enter and other competitive features.[28]

Competition drives harmful models of production

Competition at the top of concentrated industries continually leads to rapid development and broad adoption of far-reaching new technologies and production practices. For example, agribusiness giants have dramatically transformed agriculture in just the last 50-60 years.

Today food is produced on large-scale, machine- and chemical-intensive farms specializing in single animal products or hybrid high-yield crops -- one part of a segmented system involving inputs (such as seeds), farms, storage, processing, distribution, food manufacture and marketing, insurance and lending. Industrial farming deeply disrupts ecologically-based processes of plant cultivation and animal husbandry, by preventing beneficial crop interactions and complimentary relationships between plant cultivation and husbandry (e.g., on-farm manure used for fertilization), limiting fertility-enhancing crop rotations, creating uniform targets for pests, and undermining beneficial soil organisms, pollinators and natural pest predators. These conditions require the use of synthetic fertilizers and pesticides that further erode soil fertility, kill beneficial insects and accelerate the development of pest resistance, creating a systemic cycle of increasing reliance on such chemicals. Other impacts include: soil depletion; loss of arable land; energy use; impacts on wildlife; air and water pollution; ozone depletion; global warming; loss of genetic diversity; unhealthy food products; farmworker abuse and poverty; transgenic seeds; loss of farmer independence; farm failure; and breakdown of rural communities.[29]

Within such models of production, dominant corporations use their ability to influence markets for special advantage over competitors, suppliers, labor and consumers. For example, consolidation in the agricultural inputs sector allows providers like pesticide manufacturers to set artificially high prices for goods and services growers need. Likewise, concentration in commodity markets has led to artificially low farm-gate prices for what growers sell. This is one of the reasons farmers are losing their farms. While technology providers like pesticide companies market their products as solutions for low profit, technology adoption by businesses in competitive industries (such as farming) provides little lasting benefit. Production may increase, but as a new technology is broadly adopted, overall growth of supply reduces prices, eliminating the new technology's economic benefit.[30]

The general trend of innovation in production has been technologies and practices which greatly increase the use of natural resources and energy (resulting in vast resource depletion and environmental waste impacts),[31] substitute technology in place of human labor and push the limits of regulation.[32] Cases where regulatory frameworks may at best catch up to technology already in commercial use or development include food irradiation,[33] genetically engineered crops, synthetic biology,[34] nanotechnology,[35] wireless telephone communications[36] and the commercialization of outer space for communications, thrill rides, tourism and other services.[37]

Growth is imperative, yet unsustainable

Free market economies require perpetual economic growth. Sustained periods without real positive growth are characterized as recessions or depressions. They are marked by decreased business activity, increased unemployment and bankruptcies, lower incomes and demand for goods, and other aspects of economic crisis.

Arguably, the continual growth needed to keep market economies stable, particularly on a global scale, is fundamentally at odds with environmental well-being.[38] A continuous average growth of just 3% annually would mean that worldwide industrial production would double every 25 years -- clearly an unsustainable rate.[39] Agricultural expansion alone is projected over the next 50 years to cause unprecedented ecosystem degradation and species extinctions.[40]

Corporations wield extraordinary social power

As we have seen, corporations maintain decisive economic power. Yet they also exercise wide political and other social influence. In fact, in the U.S., a variety of court cases have endowed corporations with rights as "persons" under law.[41] Numerous laws, policies and international agreements have also granted corporations rights unavailable to individuals.[42]

It is important to note that many business leaders think about this influence not just in terms of government policy (such as subsidies, infrastructure, tax breaks, privatization and deregulation), but on the level of social structure. During the late Industrial Revolution in the U.S., to take a stark early example, industrialists faced a severe crisis of under-consumption, with factories producing more goods than the public wanted or could afford.[43] One banker, investor and government advisor warned: "We have learned to create wealth...[but] we have not learned to keep that wealth from choking us."[44] To bolster consumption, industrialists engaged in broad "social planning,"[45] undermining immigrant and working class values of thrift and self-reliance based on insights from the developing field of social psychology (in which one pioneer declared "It is now possible to control and regiment the masses according to our will without their knowing it"[46]). Through advertising, industry explicitly set about to instill personal dissatisfaction and fear of social censure among the public, based on insights such as "My idea of myself is rather my own idea of my neighbor's view of me"[47]. These social change efforts gave rise to modern advertising, public relations and contemporary mass-consumer culture.

Today, systemic analysis and planning takes place in exclusive clubs, private forums, think tanks, casual encounters and other settings. One such venue is the long-standing, all-male Bohemian Club annual gathering, in which George W. Bush, Henry Kissinger, the Chairman of Dow Chemical and other corporate and political elites were recent participants.[48]

[To be continued.]

==============

This article will appear in a forthcoming special issue of the International Journal of Occupational and Environmental Health.

*Skip Spitzer coordinates corporate accountability and industrial agriculture work at PANNA, Pesticide Action Network North America, in San Francisco. He has worked for almost 25 years as an activist on a wide range of social and environmental issues. As part of PANNA's Resources for Action work, he provides training in grassroots organizing, campaign development, non-violent direct action, and other activist skills.

[1] "Corporate" refers to any of several types of business which exists separately from its owners. A corporation may be in the private or public (government) sector and may be privately or publicly held (i.e., shares of ownership, or stock, are traded publicly). In subsequent usage, "corporate" and "corporations" refer to for-profit corporations in the private sector.

[2] The millennium poll on corporate social responsibility [executive briefing]. Toronto: Environics International Ltd.; 1999.

[3] Bernstein A, Arndt M, Zellner W, Coy P. Too much corporate power? Business Week 2000 Sep 11.

[4] There are of course others, such as the global Via Campesina, that make immediate demands in the context of calls and action for broader change.

[5] In Community Supported Agriculture programs, supporters help secure a farm's yearly expenses by purchasing shares of a season's harvest.

[6] For more on POPs and the Convention see: Stockholm Convention on Persistent Organic Pollutants [Web site]. Available at: URL:http://www.pops.int/.

[7] Regarding explicit opposition to activism, see: Marx GT. External efforts to damage or facilitate social movements: some patterns, explanations, outcomes, and complications. In: Zald M, McCarthy J. The Dynamics of Social Movements. Cambridge, MA: Winthrop Publishers; 1979.

[8] Biopiracy refers to the use of patents and other vehicles to appropriate the knowledge and genetic resources of traditional farming and indigenous communities.

[9] For more on genetically engineered crops see: Ho M, Ching L. The case for a GM-free sustainable world. London: Institute of Science in Society; 2003.

[10] Industrial organics share many of environmental and social impacts of the industrial food system generally. Horizon, for example, produces highly processed goods, ships long distances and undermines local producers.

[11] Sligh M, Christman C. Who owns organic?: the global status, prospects, and challenges of a changing organic market. Pittsboro, NC: Rural Advancement Foundation International USA; 2003. Also see: Pollan M. Behind the organic-industrial complex. New York Times 2001 May 13.

[12] Wakefield J. Human exposure assessment: finding out what's getting in. Environ Health Perspect 2000 Jan;108(1):A24-6.

[13] A recent study concluded that global warming might be twice as severe as predicted by the Intergovernmental Panel on Climate Change. Stainforth DA, Aina T, Christensen C, Collins M, Faull N, Frame DJ, et al. Uncertainty in predictions of the climate response to rising levels of greenhouse gases. Nature 2005 Jan 27; 433.

[14] Give Something Back [Web site]. Available at: URL:http://www.givesomethingback.com/.

[15] Dow and Habitat for Humanity: changing lives one home at a time. Available at: URL:http://www.dow.com/dow_news/feature/2004/06_18_04/index.htm . Accessed September 22, 2004.

[16] For an accessible overview of classical and contemporary social theory see: Jones P. Introducing Social Theory. Cambridge, UK: Polity Press; 2003. For a similar overview of political economy see: Sackrey C, Schneider G. Introduction to Political Economy. Somerville, MA: Dollars and Sense; 2002.

[17] Some of the ideas below are taken from the literature on the "Treadmill of Production," originated by Allan Schnaiberg. For an overview see: Special issue on the environment and the treadmill of production. Organization & Environment 2004 Sep;17(3).

[18] Bleifuss J. Know thine enemy: a brief history of corporations. In These Times 1998 Feb 8.

[19] U.S. Internal Revenue Service. Statistics of income --1920. Washington, DC: Government Printing Office; 1922.

[20] Overall, there were 5,891,000 corporations. U.S. Internal Revenue Service. IRS data book, FY 2003. Publication 55b. Washington, DC: U.S. Department of Treasury; 2004. Of these, roughly 1.5 million are non-profit corporations. O'Neill M. Nonprofit Nation: A New Look at the Third America. 2nd ed. San Francisco: Jossey-Bass; 2002.

[21] The public sector accounts for about 16% of production and the non-corporate private sector about 10%. Calculated from gross domestic product by sector data from: Bureau of Economic Analysis. Gross domestic product: fourth quarter 2003 (final). Washington, DC: U.S. Department of Commerce; 2004 Mar 25. And: Bizstats.com. Total number of US businesses [Web page]. Available at: URL:http://www.bizstats.com/businesses.htm. Accessed May 23, 2003.

[22] Other factors, such as compensation unrelated to profit, may also play a role in driving corporate behavior.

[23] The preoccupation with the need for a business case for acts of corporate responsibility is apparent in the dialogue of many in the corporate social responsibility (CSR) movement (see for example: Ethical Corporation Online [Web site]. Available at: URL:http://www.ethicalcorp.com). One CSR advocate attributed the ineffectiveness of good corporate citizenship in part to "letting business get away with cosmetic makeovers." Visser W. Five corporate sustainability challenges that remain unmet. Ethical Corporation Magazine 2004 Jul 23. Also see: Athanasiou T. The age of greenwashing. Capitalism, Nature, Socialism 1996; 7(1):1-36.

[24] Monks R, Minow N. Power and Accountability. New York: HarperCollins; 1991. p. 24.

[25] For example, economist A. C. Pigou developed an approach to address externalities in which costs are internalized through producer taxes equal to the value of external impacts. It is important to note that approaches to environmental externalities within mainstream economics emphasize the idea of pricing (if not privatizing) elements of the environment so that externalities become regulated by the market. Although these schemes ignore the impossibility of assigning appropriate values to things like streams and bacteria, they nonetheless support efforts for greater commodification of nature.

[26] The Freedonia Group. Pesticides to 2006 (Freedonia Industry Study; vol 1523). Cleveland, OH: The Freedonia Group; 2002.

[27] Eitzen S, Baca-Zinn M. Social Problems. 8th ed. Boston: Allyn and Bacon; 2000. p. 27.

[28] Note that competition still takes place in less-competitive markets. Highly concentrated markets are generally characterized by oligopolistic competition.

[29] For a broad critique of industrial agriculture, see: Kimbrell A, editor. Fatal harvest: the tragedy of industrial agriculture. Washington: Island Press; 2000.

[30] For more on this see: Ikerd J. Sustainable farming: reconnecting with consumers. Proceedings of Agricultural Leadership Foundation of Hawaii Agricultural Conference; 2002 Oct 24; Honolulu, HI. Available at: URL:http://www.ssu.missouri.edu/faculty/jikerd/papers/HawaiiSA. html.

[31] Foster JB. Global ecology and the common good. In: Grover WF, Pescheck JG, editors. Voices of dissent: critical readings in American politics. 5th ed. New York: Longman; 2004.

[32] "Labor-saving" technology of course can result in quality of life enhancements, but it also forces independent producers into wage labor, deskills the labor process, maintains a reserve of unemployed and underemployed workers, weakens labor as a class, increases scale of production and creates barriers to competition, among other important impacts. On labor impacts see: Braverman H. Labor and monopoly capitalism. New York: Monthly Review Press; 1974.

[33] For an advocate's summary of research on risks of food irradiation see: Public Citizen. The problems with irradiated food: what the research says. Available at: URL:http://www.citizen.org/documents/Research_(PDF).PDF. Accessed September 22, 2004.

[34] This term describes an emerging field in which biologists genetically reengineer and create new organisms. See: Ball P. Synthetic biology: starting from scratch. Nature 2004 Oct 7;431:624-626.

[35] On nanotechnology see: ETC Group. The big down: from genomes to atoms. Ottawa: ETC Group; 2003.

[36] See for example: Salford LG, Brun AE, Eberhardt JL, Malmgren L, Persson BR. Nerve cell damage in mammalian brain after exposure to microwaves from GSM mobile phones. Environ Health Perspect 2003 Jun;111(7):881-3.

[37] For a proponent's description of lagging regulation governing space commerce in the U.S. and the "limited regulation" of the new Commercial Space Launch Amendments Act of 2004 (now in Senate committee), see: Commercialization of space: Commercial Space Launch Amendments Act of 2004. Harvard Journal of Law & Technology 2004;17(2).

[38] For a compelling case, see: Foster JB. Ecology against capitalism. New York: Monthly Review Press; 2002.

[39] Foster JB. Global ecology and the common good. In: Grover WF, Pescheck JG, editors. Voices of dissent: critical readings in American politics. 5th ed. New York: Longman; 2004.

[40] Tilman D, Fargione J, Wolff B, D'Antonio C, Dobson A, Howarth R et al. Forecasting agriculturally driven global environmental change. Science 2001 Apr 13;292(5515).

[41] For more on corporate personhood see: Mayer CJ. Personalizing the impersonal: corporations and the Bill of Rights. Hastings Law Journal 1990 Mar;41(3).

[42] For more on the development of corporate power in the U.S. see: Nace T. Gangs of America: the rise of corporate power and the disabling of democracy. San Francisco: Berrett-Koehler; 2003.

[43] Much of the following is based on: Ewan S. Captains of consciousness: advertising and the social roots of the consumer culture. New York: McGraw-Hill; 1976.

[44] Bernard Baruch quoted in Forbes Magazine 1927Apr.

[45] Industrial retail pioneer Edward Filene in his book: Filene EA. Successful Living in the Machine Age. New York: Simon & Schuster; 1932. p. 12.

[46] Edward Bernays (a nephew of Sigmund Freud) quoted in: Ewan S. Captains of consciousness: advertising and the social roots of the consumer culture. New York: McGraw-Hill; 1976. p. 83.

[47] Floyd Henry Allport quoted in: Ewan S. Captains of consciousness: advertising and the social roots of the consumer culture. New York: McGraw-Hill; 1976. p. 36.

Industry in the U.S. explicitly set out to transform society using advertisements creating fear of social censure. A 1927 ad promoted Lysol Disinfectant as a feminine hygiene product by attributing interpersonal and social problems to a failure of personal health that the ad attributed to improper feminine hygiene. [See E. Jones, Those Were The Good Old Days (N.Y. Simon and Schuster, 1959).]

[48] Bohan S. Movers, shakers from politics, business go Bohemian: annual Sonoma fete draws Bushes, Kissinger, Powell, Gingrich. Sacramento Bee 1999 Aug 2. For more on dominant class consciousness see: Domhoff W. Who rules America: power and politics in the year 2000. Mountain View, CA: Mayfield Publishing; 1998.




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Rachel's Democracy & Health News (formerly Rachel's Environment & Health News) highlights the connections between issues that are often considered separately or not at all. The natural world is deteriorating and human health is declining because those who make the important decisions aren't the ones who bear the brunt. Our purpose is to connect the dots between human health, the destruction of nature, the decline of community, the rise of economic insecurity and inequalities, growing stress among workers and families, and the crippling legacies of patriarchy, intolerance, and racial injustice that allow us to be divided and therefore ruled by the few. In a democracy, there are no more fundamental questions than, "Who gets to decide?" And, "How do the few control the many, and what might be done about it?" As you come across stories that might help people connect the dots, please Email them to us at dhn@rachel.org. Rachel's Democracy & Health News is published as often as necessary to provide readers with up-to-date coverage of the subject. Editors: Peter Montague - peter@rachel.org Tim Montague - tim@rachel.org ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::: To start your own free Email subscription to Rachel's Democracy & Health News send a blank Email to: rachel-subscribe@pplist.net. In response, you will receive an Email asking you to confirm that you want to subscribe. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::: Environmental Research Foundation P.O. Box 160, New Brunswick, N.J. 08903 dhn@rachel.org