Review: Asthma Allergies Children

Posted on November 1, 2011 by Elisa_scoop

As an environmentalist and mom of a child with allergies, I requested a copy of Asthma Allergies Children: a parent’s guide.

The book is written by two allergy specialists in New York, Dr. Paul Ehrlich and Dr. Larry Chiaramonte, with the help of Henry Ehrlich of Third Avenue Books. (The Ehrlichs are cousins, by the way.)

First, some quick reactions: I am grateful no one in my family has severe food allergies. How frightening for parents to worry about their children going into shock, even if they come across a trace of peanuts. Likewise, it can really hinder young adults’ life when they can’t choose mates with pets, or in a case mentioned in the book, a young woman who went into shock after kissing her boyfriend who had eaten something with peanuts.

For being a book dense with scientific and medical information on allergies and asthma as well as treatment, the doctors did a good job of presenting the information in an interesting way. Their case studies of patients read a lot like case studies in a marriage column, or an episode of a medical TV show.

Finally, I learned a lot, and highly recommend this book to anyone with children suffering from allergies and asthma. The good doctors even have a website to take questions and engage the public in discussion.

For one, I learned that despite the increasing number of allergies and asthma cases in this country, the allergy specialist is a dying breed.

There are only 5,000-6,000 board-certified allergists out of 600,000 practicing MDs in the United States, and as of late 2009, just over 300 doctors were in accredited training programs for allergy and immunology, compared to more than 22,000 for internal medicine. Since allergy programs are at least two years, roughly 150 new allergists are produced each year. (Figures are from the Accreditation Council for Graduate Medical Education.) If allergists have a thirty-year career, then some 170-200 retire each year, for a net loss in the pool of board-certified allergists. The problem is complicated further by the fact that many of those residents will go into research, not into clinical practice at the same time many allergists are getting older. There’s no way to measure exactly how many of our colleagues are retiring, but when we go to the conferences, there are more doctors who look the way we do now than there were thirty-five years ago.

A large part of the problem is that insurance companies encourage primary care physicians to treat allergies rather than refer the patients to allergy specialists. As the doctors pointed out, there are many problems with this, including ordering tests an allergy specialist could have ruled out, and also not properly treating a patient, which in the long run, is costly and possibly deadly.

Still, as the doctors pointed out, it is possible to live a normal life with severe allergies and asthma, as long as patients are prescribed the correct treatment and are disciplined about taking their medications.

Here is one of the many anecdotes I enjoyed in the book:

My 12-year-old patient Mordechai was preparing for his bar mitzvah when his distraught parents brought him into the office. He was adamant about not continuing his studies, which included reading extensively from the Torah, because since he started studying the scrolls he had become congested, even losing sleep, and begun snorting. Furthermore, his friends were making fun of him because he “dripped” over everything.

“I’m not going to any more studying, and that’s that,” he said, and that was that. Oy vey!

A detailed history had revealed that he had used eight medications, but none seemed to make inroads into the problem. It became clear to me that the Torah was the source of his symptoms. Testing found him very allergic to dust mites, and as he poured over this sacred–but dusty–scroll his exposure became the issue. (Where is King Solomon when you need him?) We rapidly desensitized him to the mites (by giving him “allergy shots” or immunotherapy), placed him on a nonsedation antihistamine prior to his exposure to the Torah, and he reacted the big day without a problem.–Dr. Ehrlich

I have to say that, in Ari’s case, it was very helpful to see an allergy specialist. (Thank you, Kaiser Permanente!) I offered the doctor no other information except that congestion was causing Ari to snore and compromise his sleep. After a series of “stick” tests, I was told within a half hour that Ari was allergic to grass, ragweed and oak trees, and he was prescribed a nasal spray to sleep at night.

In the future, if Ari’s allergies worsen, we may consider more tests and even allergy shots for him. But for now, this course of treatment works. With the increasing number of cases in our country, it doesn’t make sense to do away with the allergy specialist.

Do you or your children suffer from allergies? What about asthma? Did you see an allergy specialist?

Review: Ben Behind His Voices

Posted on October 11, 2011 by Elisa_scoop

Can I say for the millionth time that I wish mental illness were treated like any other illness in this country? How often do we receive e-mails and asks from friends walking for this and that cure? How often are those cures for a family member’s bipolar disorder — or schizophrenia?

Exactly. It’s kind of taboo to talk about a mentally ill family member, which is what endeared me to Randye Kaye’s Ben Behind His Voices: One Family’s Journey From The Chaos of Schizophrenia To Hope.

Kaye is a Connecticut radio personality whose book is part memoir — specifically, her son “Ben’s” schizophrenia — and also a “how-to” manual in how to identify schizophrenia and navigate our hugely complex healthcare, and sometimes legal, system to obtain help. After reading this book, if any mom deserves a break, it is this one.

Even though Kaye was forced to raise a son and daughter on her own after their alcoholic father abandoned them, Ben for the most part is an incredibly smart, dedicated and easy-going kid. (Kaye, by the way, changed the names of “Ben” and all her relatives in the book.)

Then in high school, Ben went from a top student at a private school he had earned a scholarship to dropping out of a public high school. He had grandiose ideas of how he was going to succeed without a high school diploma, yet couldn’t even hold down a job no matter how simple. Sometimes he couldn’t even do the most basic tasks like bathe or brush his hair. Kaye took him from doctor to doctor to no avail. She almost wanted to hear that her son was a drug addict just so she had some explanation — anything — to understand what was wrong with her son.

Then the hospitalizations started. Eight of them total. Ben would lash out at his mother, who was so scared she had to call the police. Or, he’d run away and end up eating potato chips at a convenience store in a frazzled state. The store clerk would end up calling the police. At times this book was long and exhausting — like the disease itself.

And even though Ben was clearly sick, Kaye had to fight for her son to receive the care that he needed, whether it was the right medication or appropriate number of days for hospitalization. She had to switch doctors, go to court, make a lot of phone calls to the insurance company and do a lot of checking up on her son, who now lives in a group home.

The good news is he is taking his medication, which is so much better than when he was on the wrong medication or refusing to take it. The list of resources provided by Kaye is impressive and presumably useful to any family grappling with this disease.

Kaye lays out Ben’s story in great detail, too: the good, the bad and the ugly. And it is chilling.

Ben has a disability; this is the truth. His future will most probably be different because of it. When people who don’t know about his schizophrenia — people I’ve just met, or friends I haven’t seen in a long time — ask me what he’s been doing, this is how I explain it, as a disability that has made his life path a little different from the norm. This would be true no matter what kind of disability he had, physical or mental. I don’t offer any more information than this, unless they ask me more questions; I do this not to hide the truth but to wait for the invitation of their interest. At some point, though, I know that the sympathy in their expression may quite possibly turn cold. If they are not educated about mental illness, they may take refuge in the familiar stance: they try to place blame. I see it in their eyes sometimes; they think, This could never have happened to my child. I know this because I used to think the same thing, before I knew better. Mental illness doesn’t choose its victims; it randomly strikes the unlucky, even though genetics does sometimes skew the odds.

It is what it is.

Shudder. Ben Behind His Voices can be found in a number of book stores and on Amazon. For more information on author Randye Kaye, click here.

A Month Away From Your Spouse?

Posted on September 29, 2011 by Elisa_scoop

I just read this fascinating review in Slate about an author who spends a month away from her husband every year as a way to maintain their decades-long marriage.

She received a lot of backlash in the comments from people who thought there must be something wrong with her marriage if she considers this normal. But her book, The Secret Lives of Wives, presents some interesting facts. Read on:

As Krasnow writes, the idea that absence makes the heart grow fonder and all that is a cliché. But it is a cliché for a reason: A review of relevant research confirms that there can be positive aspects to time spent apart from a spouse—at least for wives. (Like Krasnow’s book, many of the sociological and psychological studies on the subject focus on separation’s impact on wives, rather than husbands.) This time apart can take many different forms: The studies don’t just talk about couples who take separate vacations or summer jaunts of the sort Krasnow and her husband have enjoyed. Research has shown that women who are married to fishermen and truckers—careers that can separate spouses for weeks or even months—also profit from time alone.

Time spent apart can benefit women by making them more emotionally self-reliant. As a 1980 study from the Journal of Marriage and Family about dual-career couples who live apart pointed out, “Wives are programmed to think of marriage as an intimacy oasis, an emotionally close relationship that will be ‘total.’ “Learning that your marriage doesn’t have to be your emotional ballast can be tremendously empowering.

There is one case where prolonged absences hurt a marriage: the military.

When one member of a military couple is deployed in a war zone. Not surprisingly, a 2010 study from the New England Journal of Medicine showed that the spouses of deployed Army members were more likely to experience depression, anxiety, and sleep disorders than the wives of nondeployed soldiers. As military wife Alison Buckholtz wrote for DoubleX in her “Deployment Diary” series, when every doorbell ringing could bring news of your husband’s death, it’s hard to see any benefit to his absence.

In the prologue to The Secret Lives of Wives, Krasnow says that the most important marital lesson she took from the hundreds of women she spoke to was the importance of maintaining a sense of evolving self, apart from one’s relationship. It’s not that geographic space is the only way of achieving a separate identity—for example, several of the wives said reconnecting with physical pastimes helped them develop their sense of self—but it is a surprisingly effective one. Healthy separation can even inspire the next generation. As Tecla, the military wife, tells Krasnow, she’s glad that she showed her children that it was possible to have adventures even when their father wasn’t around. “Now married with families of their own,” she says, “our daughters have a wonderful sense of independence and never hesitate to go off and have adventures with their own children.”

I do go on the occasional “girls’ weekend”, but usually nothing more than a long weekend. It’s more than enough time to recharge the batteries, and come back to my husband and kids fresh and motivated. A month sounds like a long time, not to mention, not practical for DH and I who both work and must help with child-rearing.

What say you? Do you think there is any truth to Krasnow’s book?

Review: What Do You Expect? She’s a Teenager!

Posted on September 26, 2011 by Elisa_scoop

Lately, I’ve had some interesting books head my way regarding adolescents and teenagers. Most recently, I read a book about tween and teenaged girls called What Do You Expect? She’s a Teenager! by marriage and family psychotherapist Arden Greenspan-Goldberg.

While I am anxious about this phase with Eli, who at 4 is already giving me a lot of attitude, Greenspan-Goldberg did a good job of demystifying teen girls and offering practical solutions on how to handle sensitive topics like sex, peer pressure and body image. Here were some eye-opening passages I highlighted for discussion:

No Punishment for Teen and Tween Girls

Part of my parenting philosophy is an emphasis on no punishment when it comes to tweens and teens. This is not because I’m a lightweight pushover. It’s for a much more practical reason that comes from years of experience as both a therapist and a mother: punishment simply doesn’t work with teens the way you want it to.

Let’s say your daughter is at a party and realizes she’s about to miss her curfew. As she’s standing on the sidewalk wondering what to do, the new kid who’s had a little too much to drink offers her a ride home. He’s a little unsteady but says he can drive just fine. Will she get into the car, or will she call you for a ride? Well, if she’s afraid you’re going to yell at her and punish her for missing her curfew, she might be tempted to get into Mr. Tipsy’s car and put her life at risk. Check out this alarming statistic: in all drunk driving fatalities, 45% of the passengers are under the age of 21 while a drunk driver is in control of the wheel. Or if he’s not as nice as he seems, she could become one of the 44 percent of rape victims who are under the age of eighteen.

On sex, Greenspan-Goldberg encouraged girls to wait because most of them are not emotionally ready for the way sex intensifies a relationship. Also, the more sexual partners a person has in their lifetime, the more likely they are to contract an STD.

Here is a line she shared to encourage girls to wait:

“This is your chance to be young,” you can tell her. “Don’t rush it.” If she says she can handle it, reply: “You don’t know what you’re in for — having sex intensifies a relationship. You don’t think so? Just ask your friends who are sexually active. They’ll tell you. You’ll feel more possessive of him, especially if he is your first love. You’ll expect him to text you constantly and if he does not, watch out!”

That said, she doesn’t think that talking about sex encourages sexual activity. But at least, anecdotally, boys can be a major source of drama for teen girls whether it be girl-on-girl fights at the cafeteria during lunchtime, or even influencing a girl’s choice of where to attend college.

There was a whole chapter on identifying mental illness, like depression, in adolescent girls, but I am going to hold off on this discussion for another book I am reading. Instead, I will share with you another eye-opening chapter on “pharm parties.” Can I say I feel old as I did not know what that was? Basically, it is a party, in which the drug of choice are prescription or over-the-counter medications.

Fast Facts on Prescription Drug Use
+One in five teens report abusing a prescription pain medication, stimulant, or tranquilizer.
+Teens abuse more prescription drugs than cocaine, heroine, and methamphetamines combined.
+According to the Centers for Disease Control and Prevention, emergency room visits for nonmedical use of prescription and over-the-counter drugs doubled during a recent five-year period. (This puts the number of medical emergencies for abusing legal drugs on par with those for illegal drugs.)
+The most emergency visits were or reactions to oxycodone, hydrocodone, and methadone: 305,900 visits in 2008, up from 144,600 in 2004.
+The anti-anxiety drugs called benzodiazepines accounted for 271,700 visits in 2008, up from 143,500 in 2004.

Have you encountered any of these issues? What are your words of wisdom?

Celebrating Hispanic Heritage Month

Posted on September 22, 2011 by Elisa_scoop

I can’t escape it. Considering my favorite radio station is in Spanish, and a lot of the media I consume is in Spanish or Hispanic-themed, I am constantly being reminded that September 15 to October 15 is Hispanic Heritage Month. I did my part to highlight the contributions of Latinos and issues affecting our community that I thought I would share with you today.

Yesterday, I helped put together a blog “carnival” for MomsRising celebrating Hispanic Heritage Month. Among the bylines are that of my fellow MotherTalkers moderators, Gloria Riesgo and Erika Chavez. My friend Xochitl Oseguera also had a story (on healthcare).

The stories range from book reviews to serious discussions about health care and fair pay, and are written by elected leaders, actresses (Jessica Alba and Paola Mendoza), policy partners, bloggers and MomsRising staffers and members.

I also had a front-page story at Moms Clean Air Force about Latino media’s leaving out clean air and clean water as important issues for our community. I wrote a similar story for the Huffington Post’s Latino Voices section.

Finally, I wrote a book review, which ran on this site yesterday, about one of my favorite authors, Esmeralda Santiago. I have a different exercise for you today: who is your favorite Latino/a author?

¡Espero que tengan un feliz mes de la herencia hispana!

Reading Corner

Posted on September 21, 2011 by Elisa_scoop

Here is a fun exercise for literary geeks everywhere: What book or author best describes you? Or, what book or author has most “spoken” to you?

For me, that author is Puerto Rican sister Esmeralda Santiago. I remember reading her memoir When I Was Puerto Rican, describing her move and transformation from Puerto Rican campesina to city-dwelling nuyorican, and feeling kinship with her. Everything about that book spoke to me from Puerto Rican culture to the feeling she had when she first stepped into an American classroom. For me that moment was my family’s move from Miami to New Hampshire.

I felt the same way when I read her most recent book, Conquistadora, which is about a Scarlett O’Hara pioneering type, a Spaniard named Ana, who talks her husband and a twin brother to run a sugar plantation with her in Puerto Rico. The time period was the same as Gone With the Wind — the early to mid-1800s — at a time when slavery was prohibited almost everywhere except for Brazil, Cuba, Puerto Rico and the United States. The tide turned when el señor presidente Abraham Lincoln signed the Emancipation Proclamation, which reverberated throughout the island of Puerto Rico as well.

I would be curious how a non-Puerto Rican would feel about this book — although it garnered excellent reviews even from non-Puerto Rican sources like Oprah! — but for me, this book spoke to me. I walked away feeling like we really are influenced by our ancestors no matter how long ago they lived. Here were some “aha!” moments for me:

• I always knew that I would keep my last name when I married. I had such a negative reaction when I’d see, especially women in Latin America, changing their last names to First Name, Last Name, “de” Husband’s Last Name. It sounded to me as if their husbands owned them. As it turns out, the root of this tradition is slavery! The slaves were given “de” plus a Spanish last name so people would know who they belonged to. I didn’t know that, but I always felt repulsed by this tradition.

• Long names never bothered me, and I actually prefer it. Both my children have first names, middle names and two last names. This is not uncommon in Puerto Rico where plantation owners, especially, wanted to give credit to all of their ancestors.

• I have always been wigged out and taken seriously anything any witch doctor or “curandera” or santero priestess would tell me. Whenever anything bad happens in my family, like the early demise of a family member, I immediately think back to the time I spoke to this or that curandero and they predicted it. I can’t shake it off. Well, these beliefs, too, come from the Caribbean where the Spanish mixed with the African slaves who brought their African Yoruba traditions with them.

• We are all mestizos, or mixed, because we come from both slave master and slave. Whenever I visit the towns in Puerto Rico or Cuba that my parents are from, I am always caught by how the girls look like me, more so than any other part of the world. They have olive skin — their skin might be darker due to the punishing sun exposure on the islands — dark eyes, and dark curly hair. We don’t look black, nor do we look white. This makes sense as many of the plantations were isolated with white slave masters — the Spanish — having no one to sleep with besides their wives and darker-skinned slave mistresses, who they would often rape and have illegitimate children with.

Other aspects of our culture are tied in this book like the Yoruba traditions, including visions — which freaked the hell out of me! — and herbal medicines introduced by the slaves, death and tragedies and our anguished Catholic responses to them. The ending is bittersweet, but realistic. I highly recommend this book.

Another way that Esmeralda Santiago and I are literary sisters? The quotes sprinkled throughout the book and the inspirations for this book came from other authors who I admire: Reinalda Arenas (Before Night Falls), Margaret Mitchell (Gone with the Wind), Alice Walker (The Color Purple), Oscar Hijuelos (The Mambo Kings Sing Songs of Love), Sandra Cisneros (Caramelo) and Abraham Verghese (Cutting for Stone).

I have read all of these books, except for Caramelo, which I have had on my book shelf for years. Now I have no choice but to read it!

Have you had authors “speak” to you like this? Make sure you write about them here!

Movie Review: The Help

Posted on August 16, 2011 by Elisa_scoop

I can’t believe I forgot to post my review of The Help! I reviewed the book here, and was offered a couple of free tickets for an advanced screening of the movie. Here is the trailer:

My thoughts? It is a long movie so prepare to sit in the theater for close to three hours. But it was true to the book, including the drawing out of the “terrible awful” by the maid Minnie. (If you haven’t read the book, trust me, this is a great plot line that is worth the ticket price!)

The book, and now movie, is about a white writer (Emma Stone) who interviews black maids for a book she pens during Jim Crow in Mississippi. There are plenty of uncomfortable scenes like the invisibility of the black maids, the hateful acts by some of the white families, and segregation. The book is controversial even today because of discomfort around white novelist Kathryn Stockett’s use of “black” dialect. Also, she is being sued by her brother’s maid who says that Stockett used her likeness and story for one of the main characters, Abilene, without permission. Here is a New York Daily News story on it.

The maid, by the way, is asking for $75,000, which, considering Stockett’s millions, is very paltry.

The book has also touched a nerve among some African-Americans because the ending is happy and optimistic, reinforcing the naivete of the “great white hope.” Here is a scathing review on it.

As a Latina and daughter of immigrants, I admit that I don’t carry the same baggage as white and black Americans do from the 1960s struggle for civil rights. I have blissfully enjoyed books like Stockett’s and classics written by other white American women like Gone With the Wind, To Kill A Mockingbird, and Uncle Tom’s Cabin. While I can understand the discomfort with white writers writing in black dialect, I can also appreciate the social taboos these writers must have encountered in their own communities for writing these books.

I also think that our discomfort with this genre of books is that this country has far from eradicated racism and segregation. The wage gap between blacks and whites is greater today than it was in 1974, according to NPR. Schools today are more racially and economically segregated than when Martin Luther King, Jr. was shot. That is appalling!

We must not allow America to forget, which is why movies like The Help are necessary reminders. Have any of you seen the movie? What did you think?

Monday Morning Open Thread

Posted on July 25, 2011 by Elisa_scoop

What’s up?

First of all, my thoughts and prayers go out to the victims and loved ones of the Oslo, Norway bombing on Friday. Here is a New York Times Magazine article on the latest death figures as well as story developments. So sad.

Also, in case you missed it, singer-songwriter Amy Winehouse died on Saturday at the age of 27.

If you haven’t already, please register for a blog radio discussion I am participating in for Moms Clean Air Force. It is an online event leading up to the BlogHer conference in San Diego next weekend. Also, if you happen to be at BlogHer, please stop by my panel discussion on Saturday, August 6 at 3 p.m.: “How to sustain an online community and keep your own sanity?” and the Moms Clean Air Force booth #732. I will be at the booth for a few hours with other members of the Moms Clean Air Force blogging team.

I admit, the next memoir I’d like to read after Tina Fey’s Bossypants — hilarious! — is Jaycee Dugard’s very serious Stolen Life. I was intrigued by this New York Times review on it.

What else is in the news? What’s up with you?

Book Review- Simplicity Parenting

Posted on July 5, 2011 by SnarkyMom_scoop

I’ve worked with Kim John Payne for many years and have been procrastinating this review for ages not because I don’t love the book, but because I struggle with it.

But now Kim’s summed up his book nicely here:

Simplicity Parenting from Kim Payne on Vimeo.

What do I love about this book? It gives me permission to not do so much. I lets me off my (self-imposed) perfect-mommy hook in a lovely way. I love the tone- it’s neither condescending (like so many parenting books) nor too glib. It honors the reality that parenting can feel just too big while also honoring that it’s not rocket science.

Listen. Watch. Be present. Lather. Rinse. Repeat.

One of the key pieces that I like is the concept of the Soul Fever. The idea is that a kid can be sick in the heart/ soul in just the same way that they get sick in the tummy or the throat. The cure is much the same- rest, quiet, and tlc. The cause is too much- too much stuff, too much activity, too much adult talk.

I struggle with pieces of this book (as Kim is aware) because we’re not a Waldorf family. Kim comes from the Waldorf world which is lovely if you can make it work. I couldn’t (not that I tried that hard), so now I’m trying to adapt Kim’s ideas to the non-Waldorf household. Some things work (less stuff, less schedule, less grown-up conversation), some don’t, some are freaking hilarious to me (like the idea of being able to get my kids to pick up their stuff every evening? BWAHAHAHAHAHA!) but would probably work well for others.

Is it worth a read? Yes. Do I think our Katie would make mucho comedic hay out of it? Absolutely. Different strokes and all that. But there’s good stuff in here and you should check it out if you get a chance. It’s worth a read. (And let me tell you- if you ever get a chance to hear Kim speak in person, GO! He’s a freakin’ mesmer- and charming as all get out.)

Review: Profit At the Bottom Of The Ladder

Posted on June 29, 2011 by Elisa_scoop

Since coming back from Netroots Nation, I have been thinking a lot about workers’ rights. When did we get to the point in our country that workers like teachers and union members are the greedy and grubby ones? No one seems to care that much about the investors who don’t have to work, for example. Or asking the CEO to take a pay cut, or even worse, pay more in taxes. Gasp!

Finally, I spotted a story, in this case the Washington Post, scrutinizing CEO pay, which is at the highest levels in our history. Read on:

The evolution of executive grandeur — from very comfortable to jet-setting — reflects one of the primary reasons that the gap between those with the highest incomes and everyone else is widening.

For years, statistics have depicted growing income disparity in the United States, and it has reached levels not seen since the Great Depression. In 2008, the last year for which data are available, for example, the top 0.1 percent of earners took in more than 10 percent of the personal income in the United States, including capital gains, and the top 1 percent took in more than 20 percent. But economists had little idea who these people were. How many were Wall street financiers? Sports stars? Entrepreneurs? Economists could only speculate, and debates over what is fair stalled.

Now a mounting body of economic research indicates that the rise in pay for company executives is a critical feature in the widening income gap.

The newspaper brilliantly compared the life of a milk company CEO in the 1970s to today. It is eye-opening.

Along this theme, I just finished reading a book about the value of investing in our workforce: Profit at the Bottom of the Ladder: Creating Value by Investing In Your Workforce by Jody Heymann with Magda Barrera. I loved this example of Costco in the book:

“Hiring and training new employees is expensive, so Costco figures their low turnover rate makes up for the higher pay,” George Whalin, president of Retail Management Consultants, noted. Past the one-year mark, Costco has one of the lowest turnover rates in the industry. According to a 2004 article, Costco’s overall turnover rate was 24 percent a year, which was less than half of Wal-Mart’s turnover rate of 50 percent. Beth Hall, a deli manager who has worked at Costco for ten years, discussed the importance of wages in her decision to stay at Costco, stating that she expected to work there long term: “(I’ll stay here) forever. You can’t earn this kind of money anywhere (else) without a college degree.”

CFO Richard Galanti was clear on how Costco was able to afford better wages: “The fact is that we have the ability to afford a higher wage because even if we’re paying a $4 to $5 an hour higher average wage than Sam’s (Club), we’re doing almost twice the sales — 70 percent more per square foot.” Costco’s finances also benefit from its extremely low shrink rate, which refers to the amount of merchandise lost to employee theft. According to Vito Romano, “The industry average is somewhere between 2 and 4 percent. We’re at less than 0.02 percent.” Jim Sinegal concurred that good wages and benefits are the reason that Costco has extremely low rates of theft by employees.

This, and the fact that Costco doesn’t even have a PR department — it naturally gets a great reputation for the way it treats its workers — makes me want to renew my Costco membership. It’s two towns down from us, which is why I stopped going. But if I ever need anything from a Target-like store, I am going to go there instead.

Costco is onto something that CEOs should take note:

Building and maintaining a good corporate reputation is critical to success. In fact, surveys have shown that most CEOs consider their company’s reputation to be their most important intangible asset. With increasing public attention being paid to companies’ global footprints, most firms at least state their intentions to be socially responsible. After a series of public relations scandals over goods produced under sweatshop conditions, more firms have begun to recognize the necessity of paying attention to working conditions in their operations in all countries.

We should reward companies that treat their employees fairly. Which leads to my last point on this book: there were so many companies — big and small — attempting to do right by their employees all over the world. Companies like Costco, SA Metal Group, Novo Nordisk, and Dancing Deer. Not only should consumers take notice, but I wonder how much more effective non-profit organizations’ work would be if they partnered with private companies as opposed to only other advocacy groups?

I would say that Profit At The Bottom Of The Ladder should not only be required reading for companies and legislators, but also advocacy and consumer groups.

Rants and raves on modern motherhood

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