Soundings

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After they’ve greeted us at the front desk, many savvy patrons of the Edgartown Library head straight for the shelves we keep stocked with books, videos, and music disks newly added to the collection. One of the joys of libraries across the Island is that you can read a review of a movie just released on DVD, or a new book or music album, and find it on your next visit to the library.

Now, buying this wonderful new material costs money, and all the Island libraries do belong to CLAMS, the regional network of libraries whose total collection amounts to some two million items. So if one town were to hit a tight budgetary year, wouldn’t it be tempting to trim the acquisitions budget and just let townspeople borrow new materials from other libraries in the network?

Here’s why doing this is a bad idea: just think what would happen if everybody did.

And since 1890, the commonwealth has set standards for libraries to ensure that they play nicely together. To keep its certification, each town library must meet standards for the purchasing of new materials, for staffing and open hours, and for total operating budget. When the state decertifies a town library for, say, skimping on new materials, that library’s patrons lose the right to borrow materials from other libraries across Massachusetts.

The state’s library standards are a classic example of rules we need to keep the game fair and square. These rules are healthy for everyone for the same reasons we place a minimum size on harvested scallops and lobsters, the same reasons we restrict the pollution that factories can release into our air.

As a society, we agree on rules like these when the rational choices of one individual or enterprise might run contrary to the best interests of the group. In his seminal essay, “The Tragedy of the Commons,” published in the journal Science in 1968, the ecologist Garrett Hardin concluded that the only solution to this conflict between individual and group is what he called “mutual coercion, mutually agreed upon.” In other words, rules — and consequences for breaking them.

I know this might seem an unlikely leap, but I’ve been thinking about Hardin’s essay and the rules of library certification since reading Nathaniel Horwitz’s excellent piece (April 16, “Martha’s Vineyard students lag in required vaccination”), published in this newspaper in April, on the disturbingly high numbers of children in our up-Island public schools whose parents have chosen not to have them vaccinated against such diseases as mumps, measles, and whooping cough.

In the three public schools up-Island (Chilmark, West Tisbury, and Charter), The Times found, the parents of 105 students signed and submitted papers declaring that the vaccination of their children conflicts with their “sincere religious beliefs.” In addition to being an abuse of the word “sincere,” I’d suggest that this also insults the people of faith across the Island who actually do try to live by a religious creed.

I’m afraid that no amount of scientific evidence — and it is already overwhelming — will persuade those parents who have decided vaccination poses some slight statistical danger to their children. This is a subject much like global warming, where deniers of the scientific consensus will always be able to find an anecdote to support their view, an outlier scientist or afringe group’s website whose work they can cite.

As with climate change, although the deniers will always be with us, the science is settled and the consensus is strong that vaccination is a cornerstone of sound public health. It’s time for our community to consider the alarming numbers of unvaccinated children attending our schools — as many as one-third of the enrollment in Chilmark — and to apply some mutual coercion here.

For a parent to weigh the small risks of vaccinations against the serious epidemiological consequences if everyone opted out, and to opt out anyway, is a gesture of selfishness that borders on the antisocial. It’s a sort of parasitism, really, taking advantage of the healthy practices of others.

Ironically, it’s the very success of vaccination as a public health practice that enables the exempters in our community to make these wrong-headed decisions. We’ve had such success suppressing diseases like measles and whooping cough that most parents haven’t seen them, and can fixate on the imagined risks of a vaccine rather than on the real dangers of the illness it helps to prevent.

A fisherman who illegally harvests short lobsters or undersized scallops is banking on the hope that everyone else doesn’t do the same and destroy the shared resource. A parent who doesn’t immunize a child had better hope that enough other people immunize their children so that nasty and sometimes fatal childhood diseases can’t attack their community.

Right now, too many up-Island families aren’t thinking this through properly, and a real public health threat is the result. It’s time for us to agree that while parents may have the right to refuse vaccinations for their children, the community has the right to tell them that if they do, they give up the right to enroll their children in our public schools.

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For most hours of the day this summer, the Vineyard Transit Authority buses that ply Route 1 between Vineyard Haven and Edgartown will no longer run on a fixed schedule. The VTA has added a fourth bus to the route, and keeps in radio contact with the drivers to time their trips so that ideally, as two buses pass near the roundabout, the other two are departing from the endpoints.

In the transit business, this way of scheduling buses is called headway mode. What it means for riders on the Island’s most important commuter corridor is that the new service might not be as precisely predictable as before, but you should never have to wait more than seven or eight minutes for a bus.

Adding that fourth bus involved an expense, says Angie Grant, administrator of the VTA since 1996, but the good news is that public funding for transit systems has recently become more reliable. The model is shifting from funding in arrears to funding in advance, which means that administrators like Ms. Grant can spend more of their time figuring out how to serve their riders better and less worrying about what to do if their expenses aren’t covered.

No public service on Martha’s Vineyard has rocketed from nonexistent to indispensable with anything like the speed of the VTA. Year-round bus service here didn’t exist before 2006. In the fiscal year that ended just a few days ago, the VTA was on track for a record ridership of more than 1.2 million on its fixed bus routes.

Last August, the VTA carried 303,175 passengers, an increase of nearly 30 percent for that month since 2006. But even more dramatic is the doubling in ridership the VTA has seen in the dead of winter: to find a month when the service carried fewer than 20,000 people, you have to go back to February 2011.

Here’s another indicator that puts the growth of this Island service in perspective: At present, Massachusetts has only three public transit authorities operating seven days a week, year-round. They are the MBTA in Boston, the Pioneer Valley Transit Authority (serving two dozen towns and cities in the Springfield-Amherst region), and the VTA.

Visiting the website of the transit authority this week, I found this on the FAQ page: “Q: Do I need to bring my car to Martha’s Vineyard? A: No.” This little exchange should be a favorite for anyone who suffers the summer crawl through Five Corners in Tisbury or Upper Main in Edgartown. In fact, the VTA has an excellent page of advice for visitors interested in seeing the Vineyard in a single day without the hassle of bringing a car or the risk of renting mopeds and adding the hospital to their itinerary.

The VTA is a rural transit system for nine months of the year, and an urban system for three. Because it’s impractical to own two fleets of buses, and because the VTA has to be equipped to handle the peak load, there are times in winter when the rolling stock isn’t an ideal match for the demand — and Ms. Grant does hear occasional complaints in January about big buses with few passengers inside. But she rightly points out that even a bus with only half a dozen passengers is burning less fuel per passenger-mile, and putting fewer pollutants into our air, than if those riders were driving cars.

(The environmental benefits of public transit, by the way, are steadily improving: Today’s bus engines emit 85 percent fewer particulates than those the VTA was using just six or seven years ago.)

Looking to the future, says Ms. Grant, the VTA will continue to look for ways to improve its service to its more than one million riders each year. One of the biggest changes likely in the years ahead, she says, will be the jump to buses twice an hour on the system’s up-Island corridors during the busy season. “It’s a big jump,” admits Ms. Grant, “but it’s the next logical step.”

Meanwhile the seasonality is intense, the mix of users is diverse, and the challenge for the VTA is always to strike the best balance.

“This is an essential service, as much as we might not want to admit it,” Ms. Grant says. “We have a lot of ‘choice’ riders here, and we’re fortunate for that, but there is a transit-dependent population on Martha’s Vineyard. They might be elderly, they might be disabled, they might just not be in a position to own a vehicle because of the economics of it.”

In the end, the biggest group benefiting from the services of the Vineyard Transit Authority might be those of us who use the buses rarely or not at all. The next time you’re behind the wheel, inching into Edgartown one car-length at a time, consider how much more unpleasant your trip might be if that VTA bus ahead of you were three dozen individual cars.

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I was diagnosed with mild high-frequency hearing loss as a child, probably related to early ear infections and fevers. I remember a specialist telling my parents, “He’ll be fine, but he should stay away from loud machinery.”

I went on to spend 24 years at the Vineyard Gazette, logging thousands of hours in the production room where the four-unit Goss Community press, once brought up to speed, shakes the building and sounds like a locomotive under throttle.

In June of 2006, I took a job in a quieter setting, at the Edgartown Library. That summer a parade of people came to the front desk and asked for help in their best library voices. My responses were variations on the theme of “Could you speak up, please?”

My library colleagues suggested, in the kindest terms, that I have my hearing checked — and soon I was fielding patrons’ questions more nimbly, thanks to a pair of hearing aids that set me back a month’s pay but have served me ably now for almost eight years.

Several of my Island friends, noticing the new wires and the tiny Oticons behind my ears — I will admit to being inordinately proud that they’re made in Denmark — have asked me about them, and have ended up being fitted for hearing aids themselves. And several of their spouses have made a point of thanking me. Because hearing is one of the most profoundly social senses, and when hearing is improved the benefits accrue to both the listeners and the people who speak to them.

Hearing aids have improved greatly over the past decade, but they still can’t do for hearing what eyeglasses can do for sight. You can enjoy 20/20 vision with the right optics, but even the best hearing aids don’t restore the acuity of human ears at their youthful, healthy best. I’ve become an aficionado of acoustic spaces, because one of the greatest challenges to my hearing is background noise. When we go out for dinner together, my wife and I pick restaurants as much for their quiet, which means we’ll be able to enjoy our conversation, as for their cuisine.

I’ve also become sensitized to the way hearing loss is treated as a poor stepchild in the family of disabilities. Medicare and most insurance plans generally don’t pay anything toward the considerable cost of hearing aids, which is one good reason why an estimated 80 percent of the more than 35 million Americans with hearing loss aren’t wearing them.

Across the Atlantic, the European Union has its own version of our Americans with Disabilities Act, and it requires that public spaces include a technology most Americans haven’t even heard of. It’s the hearing loop, also called the audio-frequency induction loop or AFIL, and it sends an audio signal into any pair of hearing aids fitted with a telecoil.

In a widely-circulated New York Times story three years ago, the composer Richard Einhorn described hearing a performance of the musical, “Wicked,” at the Kennedy Center in Washington after the center was fitted with a hearing loop system.

“There I was at ‘Wicked’ weeping uncontrollably — and I don’t even like musicals,” he said. “For the first time since I lost most of my hearing, live music was perfectly clear, perfectly clean and incredibly rich.”

Hearing loop systems are ubiquitous in Europe — every London taxi cab has one — and nearly all hearing aids sold there are equipped with the telecoil that receives their signals. But on this side of the water, we’re way behind the curve.

Massachusetts has just a handful of hearing loop systems in public spaces. They’re being used in half a dozen places of worship — the nearest are St. Peter’s Church in Harwich and the Cape Cod Synagogue in Hyannis. The meeting room of the Dennis Public Library uses a hearing loop; so do Logan Airport in Boston and the Coolidge Corner Theatre in Brookline.

On Martha’s Vineyard, any public space would be well served by the addition of a hearing loop. Church halls and performing arts spaces, selectmen’s meeting rooms, library program rooms, senior centers and our district court are among the prime candidates for a technology that promises to deliver clearer sound to the growing number of people with hearing aids. And as the loops become more common, hearing aids fitted with telecoils will become the standard, just as they already are in Europe.

Fortunately, the cost of this new technology is low. Most public spaces can be fitted with a hearing loop for about $10,000 — the price of two pairs of high-end hearing aids. Here’s hoping that someday soon, we’ll begin to see the hearing loop logo in the doorways of Vineyard spaces, promising help for hundreds of listeners in carving out meaning from the background of noise.

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— Photo Courtesy of Picasa

When Peter and Nancy Shemeth were wed in 1975, he married not just into a family but also into an important piece of Edgartown’s civic life. Nancy’s father, Alfred Doyle, was fire chief. So it seemed only natural for young Peter, then 23 years old, to join the Edgartown Volunteer Fire Department in 1976.

“A lot of the people I associated with socially were also members of the fire department,” recalled Chief Shemeth, who has led the Edgartown department now for eight years, in a conversation at the department’s offices last Friday that also included Deputy Chief Alex Schaeffer. “It was just the natural next step to join. And from there, it was a progression.”

Mr. Shemeth was assigned to the department’s aerial ladder truck — a Farrar model bought by the town in 1971 — and worked his way up to lieutenant and to captain of the ladder truck for some 25 years. He served as assistant chief under Antone Bettencourt, and became chief of the department in 2006.

The continuities in a small town volunteer fire department run deep. Today, as when he first joined up, said Chief Shemeth, “It’s a brotherhood.”

But forces of change have also been at work. One dramatic difference today is the amount of training involved in becoming a volunteer firefighter. When he first joined the department, Chief Shemeth said, “There wasn’t the formal training we have today. You were taken through your truck until you knew everything about it, and then every once in a while you’d have an all-department practice. Now, the state says you have to be Firefighter One trained; you have to be first responder trained; you have to have CPR and hazmat training. Realistically, it probably takes two years to go through all the training.”

A second big difference relates to the rhythms of Island life. “Everybody back then had a lot more time on their hands than they do now,” Chief Shemeth said. “Young people now are working one job and possibly two, trying to make ends meet.”

Combine the new training requirements with the more hectic pace of Vineyard life, and the result is that Island fire departments are finding it more difficult every year to recruit the volunteers they need. Chief Shemeth doesn’t blame the younger generation: “As for the volunteer aspect of it, I think the majority of people still have that: they still want to get involved and give back to the community. But it’s becoming harder and harder to give the amount of time that’s required.”

Since 1970, the population served by our Island fire departments (and the numbers of flammable structures dotting our landscape) have more than tripled, even as the ranks of volunteer firefighters have begun to ebb. Fortunately, another generational change has come along to make firefighting on the Island more effective: The separate town departments work together more closely, and more smoothly, than they did just a couple of decades ago.

Chief Shemeth recalls how, during his early years with the Edgartown department, calling for mutual aid from another town was rare, something to be avoided. “You didn’t want to call in mutual aid from another town, because that meant you couldn’t handle the situation yourselves,” he said. “You just didn’t call another town unless it was hitting the fan.

“Now that’s changed, because people are so much busier, you don’t have the luxury anymore of everyone being available to show up during the daytime. Now, if Oak Bluffs or Vineyard Haven or West Tisbury gets a working structure fire, it’s a mutual aid call for one of the neighboring towns — that’s just standard procedure now.

“I look at it, whatever we can do for another department, I’m more than happy to send our personnel and our equipment. Because I know when I need them, there’s not a question: they’ll be here. Now, when we even think we might need mutual aid, we’ll call them and put them on standby.”

So the Island fire departments have met some of the impact of the changes felt in recent years by working better together. But if present trends continue, Chief Shemeth says, we may have to look at adjustments, much like those our emergency medical services have already seen — a shift to a heavier reliance on paid staff.

Neither Chief Shemeth nor Deputy Chief Schaeffer looks forward to this. “The heartbreak that I see in the loss of volunteers in the mix,” said the deputy chief, “is the loss of diversity in the department. I mean, beyond just the camaraderie and the social aspect of it all. Right now, when we have 44 volunteers show up at a scene, we have 44 different perspectives of people who work in different fields and are expert in those fields. You have the builder who knows the framing; you have the plumber who knows the heating system. You have all this knowledge at your disposal at any given time, and that’s tremendously useful.”

The 1971 Farrar ladder truck that Peter Shemeth captained for so many years was replaced in 1995 by a new model. Mounted on the front bumper of that truck is the silver bell that adorned the Farrar and dates back to its predecessor, the 1938 City Service Mack that served the town for more than three decades.

Handed down like that silver bell, the Shemeth family tradition of service continues in the generation of Peter and Nancy’s daughters, Kara and Justine. Kara is a member of the Edgartown Fire Department and an EMT. Justine’s husband, Paulo DeOliveira, is also an Edgartown firefighter and EMT.

Chief Shemeth loves these continuities, and he cherishes the traditions of volunteer service that run through all the Vineyard’s fire departments. “You want to keep the volunteer system as long as it’s viable,” he says. “But we do have to start planning for the future. Because there will come a day.”

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In 2011, with an Edgartown Library building project on the town meeting warrant, I was hired to help prepare an informational brochure for voters. For the back cover, I asked several town leaders for endorsements of the library plan. They were universally willing to help — well, almost universally.

The only person to turn me down, flatly refusing to endorse the plan for a new library on the site of the former 1924 elementary school, was Pat Rose — chairman of the library trustees and a director of ELF, the Edgartown Library Foundation

Site of the new Edgartown Public Library.
Site of the new Edgartown Public Library.

This was three years ago, when the ink was hardly dry on plans for a new library at the school site. Bitter opposition to the abandonment of the North Water Street site still ran deep in some quarters — including the library trustees and the leadership of ELF, which had been raising money for a new library on that site for years.

A pause, here, for full disclosure. In addition to serving as Edgartown’s reference librarian since the summer of 2006, and working in a freelance capacity on copy for that informational mailing in 2011, I also did a brief but intense stint of work on the wholesale rewriting of Edgartown’s $5 million state grant after the decision, in late 2010, to build at the 1924 school site. Looking back on the drama of the past seven years, and ahead to the prospect of breaking ground later this month for a new Edgartown Library, I must say that in my more than three decades on the Island, I’ve not seen a more fraught public process with a more wonderful final outcome.

ELF’s most successful fundraising years, according to its own tax filings, spanned from 2007 through 2011, when it raised a total of $606,284. After expenses and grants to the library, ELF reported $462,809 in its coffers at the end of 2011.

Edgartown Public Library on North Water Street.
Edgartown Public Library on North Water Street.

But remember, this money had been raised during a time when most library supporters thought the new building would be on North Water Street, with the historic 1904 Carnegie library as its centerpiece. And during this period, because ELF’s leadership included library trustees and even the library director, the foundation felt comfortable making promises to donors about “naming opportunities” — a common practice in the library fundraising game.

West Tisbury has a clear policy on naming opportunities, and its library foundation has raised $750,000 in pledges for the building now nearing completion. But Edgartown never adopted written guidelines on naming opportunities. And now ELF claims it can’t hand over some $300,000 it has raised because of promises it made back in the day, absent clear guidelines, but with the understanding that because ELF and the trustees had this overlapping membership, things would somehow all work out.

Well, things haven’t worked out. The library trustees most resistant to the new school site were swept from office in Edgartown’s 2011 elections — but they still hold the foundation’s purse-strings.

If you’re following the math, ELF does have a certain amount of unrestricted money, and in fact, the foundation was poised to hand $175,000 over to Edgartown at a wine-tasting at Lattanzi’s last year. But just days before that event, the foundation directors — in a sharply divided vote and arguably one of the dumbest moves in the organization’s history — decided not to write the check. This is when the real political hardball began.

Almost immediately, the new library trustees asked ELF to stop raising money for the library, to stop representing itself as the library’s fundraising organization, and to turn over its funds to the town. Edgartown instructed its counsel to ask the state attorney general whether ELF can be compelled to hand over what it has raised.

Meanwhile, since that moment at the end of 2011 when ELF reported net assets of $462,809, those funds have been steadily shrinking. In 2012, the foundation’s two fundraising events raised $32,000, but cost $36,000. (Maybe we should call them fund-losers?) And in 2013, ELF spent an undisclosed amount of its unrestricted funds — in what has to be this story’s ironic high point — on attorney’s fees, defending its right to withhold its money from the very institution for which that money had been raised.

What an incredibly hollow victory for ELF to say look, we’ve been vindicated — we don’t have to give this money to the library now if we don’t want to. I’d say it’s time for the directors to engage in some somber reflection on their organization’s mission statement. (It’s also past time, incidentally, for ELF to spend some time on its website, which proclaims, “2012 should be an exciting year!”)

Only by talking to some of the players, as I have done, can you appreciate how deep the animosity runs on both sides of this controversy. To date, playing hardball has cost both Edgartown and ELF money that could have been spent on library services for townspeople. Lawyers may ultimately be needed to help sort out how to use the restricted $300,000 in ways that honor the intent of the donors. But what’s needed now is not more adversarial litigation.

It’s time for ELF to put all its funds squarely on the table, and to work with the town toward a solution. Something as simple as a plaque in the new library’s entryway, and some conversations with donors, might be all that’s needed to resolve this mess.

Finally, with all this said, a bit of perspective. The disputed $300,000 represents less than three percent of the new library building project, which has been funded equally by the taxpayers of Edgartown and by a gift from the state. Groundbreaking for the new library will take place in the weeks ahead, and Edgartown should be enjoying a fantastic new facility sometime in the summer of 2015. And if you’re a library supporter wondering how you can express your support for the building project at this moment of estrangement between the foundation and the town, there’s an easy answer: Edgartown has set up a municipal fund to accept your gifts.

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Stop & Shop’s proposal to shoehorn a new, 30,477-square-foot building into 29,047 square feet of land on Water Street in Tisbury has been under scrutiny ever since last February, when it was referred to the Martha’s Vineyard Commission. Recently we’ve heard members of the MVC complaining that the review process is dragging on, but wait a minute: if ever there was a case to be made for measuring twice and cutting once, this is it. This location is the unavoidable, un-drive-aroundable, year-round entryway to the Island, and its traffic empties directly into Five Corners, the failed intersection so complicated and congested in the summer that (with apologies to Yogi Berra) nobody goes there any more — it’s too crowded.

So thank you, Martha’s Vineyard Commission, for taking a few extra months to look at this project carefully.

Traffic and building scale have emerged as primary concerns in the MVC’s deliberations, and understandably so. But I’m equally concerned about an issue that’s being eclipsed by the supermarket’s proximity to Five Corners, the Island’s black hole of traffic physics.

The issue that resonates so strongly with this proposal from Stop & Shop — a business that is at once one of the Island’s largest employers, and one of the poorest-paying — is affordable housing.

Just two months ago, the Wal-Mart retail chain made national news when the press got hold of a photo from the staff area of a Canton, Ohio, store. “Please donate food items here,” said the sign, “so Associates in need can enjoy Thanksgiving dinner.” Here was the nation’s largest retailer, seemingly admitting that its workers need a canned food drive to get by on their paltry wages.

In a way, the Island’s Stop & Shop stores are our very own Wal-Marts. The Stop & Shop chain is owned by the giant Dutch supermarket company Ahold, which lately has been posting net profits of more than $1 billion per year.

According to documents filed by Stop & Shop with the MVC, the Tisbury supermarket currently employs 96 people in-season — 85 of them part-time workers and just 11 full-time. The chain proposes to employ some 160 people in-season at its new, larger store. Again, more than 80 percent of them will be part-timers. So the expanded store does mean more Island jobs, but very few of them will be the sort of jobs the Vineyard economy urgently needs.

Wages of ten bucks an hour, even working full-time, simply can’t sustain a decent life on Martha’s Vineyard. By loading up on part-timers whose access to benefits and collective bargaining is limited, part-timers whose hours can be cut back just when the hard winter months begin, Stop & Shop manages to simultaneously bolster its corporate profits and shift the burden to the Island community.

The directors of the Dukes County Regional Housing Authority, in letters to the MVC, have asked for better numbers on how Stop & Shop employment practices impact the Island’s housing needs. The Commission can require the applicant to mitigate the impact of its building expansion on the Island’s housing problem, but to date I’ve seen nothing that reassures me that the agency has looked hard at this issue. Notably, in the MVC’s November staff report on the Stop & Shop application, the historic value of the house at 15 Cromwell Lane makes the short list of key planning concerns to be considered — but housing impacts do not.

David Vigneault, executive director of the regional housing authority, tried to raise awareness of this issue in an August letter to the MVC. “At any point in time over the last decade,” he noted, “a minimum of six to twelve S&S employees have utilized affordable rentals offered by the DCHRA and other Island housing organizations, with another half-dozen using rental assistance of one sort or another.”

We all need groceries, and we all need cashiers at the check-out lines to take our money and bag our food. Right now, those cashiers receive an unlivable wage, and the community pitches in with property tax dollars to help pay for the housing our Stop & Shop employees can’t afford.

All across the country, this shifting of costs from the private to the public sector is the Wal-Mart way. But do we really want it to be the Island way?

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Let’s try to connect the dots between a new book on public health policy, a promising new program at Martha’s Vineyard Hospital, and some numbers from a century-old Edgartown annual town report.

First, the book. In “The American Health Care Paradox,” by Dr. Elizabeth Bradley, director of the Global Health Leadership Institute at Yale University, investigates how the United States manages to spend more per person on health care than any other nation on earth, yet ranks back in the pack in measures of outcomes such as longevity and infant mortality. One reason for this apparent paradox, Dr. Bradley argues, is that we’ve defined health care far too narrowly.

When you look at human services more broadly — including things like public education, housing support, job training and unemployment benefits, daycare for children, pensions and other programs caring for the elderly — our poor outcomes in the United States line up very well with our poor patterns of public spending. We might not think of these non-medical services as health-related, but in fact unmet social needs have very direct impacts on public health.

Even in the field of medical care, where so much of our money is spent, the realization is growing that health outcomes improve when we expand our vision to include the social world in which patients live their lives. At the Martha’s Vineyard Hospital, a new program called Integrated Care Management was launched in April to reach into the Island community and support people whose cases involve chronic and medically complicated conditions. Since a great deal is actually known about how to manage chronic ailments such as heart disease and diabetes, an outreach program can support people in the good habits that prevent the sorts of costly medical train wrecks that happen when a condition, left unmanaged, repeatedly requires hospitalization.

The Vineyard hospital’s Integrated Care Management program is based on a pilot project developed at Massachusetts General Hospital that showed great promise in achieving the prized twin goals of modern day health care reform: better health in the community with lower costs of care. The guess here is that the Island’s version of this program will accomplish exactly the same things.

Next, a bit of history. Recently, reading in the Edgartown annual town reports of a century ago, I was surprised to see a large portion of the municipal budget being spent every year in a category labeled “Support of Poor.” In Edgartown in 1914, “Support of Poor” accounted for some $2,500, nearly 11 percent of the town’s operating budget.

Digging further, I discovered that the town, as the unit of government responsible for basic social services, is a New England tradition that goes back to English law, where the care of the needy was the duty of the local parish. Under Massachusetts law dating to the late 1700s, larger towns appointed overseers of the poor, while selectmen in smaller towns like ours also held that post as a second responsibility. In 1914, Edgartown paid Edwin Coffin, William C. Nevin, and Alfred A. Averill $170 each for their work as selectmen and overseers of the poor.

The town report’s itemization of expenses suggests the range of social services supported in this category. Fully half the money, more than a thousand dollars, went to rent subsidies. Money also went for groceries, winter fuel, clothing, medical care and other basic needs — including $15.20 to Silva Shoe Co. for shoes and $38 to Francis W. Pent for burial services.

Such basic human services haven’t been funded by property taxes around here for many years — and you could make an argument that in some ways, it’s a pity. Now we have huge federal and state programs ministering to some of the Island’s social needs, and a diverse, dedicated but always needy network of nonprofit agencies at work here. Too many of the state programs are headed with the label, “Cape-and-Islands,” code language for agencies headquartered on the mainland and better at requiring paperwork than at providing access to services for the people here who need them. Meanwhile, our nonprofits have their boots on the Island ground and a deep, nuanced understanding of local needs, though seldom the resources to address them fully.

I’d love to see our towns, in a tip of the hat to the way Islanders cared for each other a century ago, apply a property surtax of one or two percent each year and pass that along to the agencies on the front lines of social services here. But until that happens, we need to provide in our holiday giving for those Island organizations that labor every day on the social front lines, delivering the human services that hold this community together.

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Since 2009, the federal Centers for Disease Control and Prevention has had a policy on transportation infrastructure, recommending that state and local governments embrace the policies of the National Complete Streets Coalition. If it seems odd that a health agency should take a position on the engineering of our streets, consider how closely the question of how we get from Point A to Point B is tied up with pressing issues of public health.

Our health, it turns out, is the result of myriad small decisions. Should I order the cheeseburger or the salad? Drive to work today or bicycle? Watch that Netflix movie or take an afternoon walk? And to the extent that the design of our communities affects these small decisions, our public expenditures on things like safe sidewalks and bicycle paths play a part in weakening or strengthening the public health.

Some recent surveys have raised the disturbing possibility that our children may be the first generation in many with a life expectancy shorter than that of their parents. Foremost among the culprits behind this decline in lifespan are obesity and its confederates, heart disease and diabetes. And last week in these pages, you read news of the recently completed study by the Rural Scholars, which finds that the children of Martha’s Vineyard are not immune to this national trend.

Peg Regan, who served as principal of the Martha’s Vineyard Regional High School for nine years, recently completed a two-year stint as Island director of Mass in Motion, a state initiative aimed at changes that enable people to eat healthier and move more. The recent study results on childhood obesity here, she says, were somewhat unexpected: “One assumption we made was that since we don’t have fast food restaurants on Martha’s Vineyard, kids would not have access to that kind of food, and we might in fact have lower BMI [body mass index] averages because of that. But that has just not proven to be true.”

Ms. Regan has worked with the schools to improve the healthy fare being served in lunchrooms across the Island, and the advances on this front have been dramatic. Thanks to new state rules, leadership from the superintendent’s office and cooperation with the Island Grown Initiative, school lunch menus today are far healthier than they were just a decade ago.

But changing habits of physical inactivity has been harder, Ms. Regan admits, because one important part of encouraging new habits is providing the public infrastructure that makes them practical and enjoyable for people in their everyday lives.

And for the past half-century and more, the main focus of our provisions for getting people from one place to another has been that most American of machines, the automobile.

Happily, however, there are signs that this focus is beginning to broaden. Recently, when Skiff Avenue in Vineyard Haven was repaved, a bicycle path was clearly marked along one edge of the street. It’s still a steep climb for cyclists leaving Vineyard Haven for Edgartown, but now it’s far safer, and the only public expense involved was a bit of paint.

The new roundabout in Oak Bluffs is a terrific example of how modern engineering can provide well not only for automobiles but for all users. Navigating the roundabout is a joy now for cyclists and pedestrians, thanks to the islands that provide safe pausing-places halfway across.

During her tenure as director of Mass in Motion, Ms. Regan made the rounds of the Island towns to suggest that they adopt, as bylaw, a Complete Streets ordinance like those already implemented in the Massachusetts towns of Plymouth and Northampton. The bylaw is fairly simple as these things go, stipulating that whenever a town undertakes a road project, it should be designed for the convenience and safety of all users — not just drivers of cars, but also riders of mass transit, pedestrians, cyclists and the disabled. The Complete Streets bylaw doesn’t call for costly, wholesale change, but for an incremental approach that considers all users of our transit infrastructure and provides for them, where feasible, at the most convenient and economical moment — when we’ve already decided to build or rebuild a section of road.

Peg Regan’s efforts to advance local adoption of Complete Streets bylaws were not well received in town halls across the Island, which is too bad. Because when we improve a street to make it accessible for everyone, we transform a barrier to public health into an asset. Every initiative that encourages even a few of us to get out of our cars and choose instead one of the alternatives — be it public transit, bicycling, or walking — is an initiative that advances the public health and improves the quality of life on Martha’s Vineyard.

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Tax subsidies are a wildly popular way for Congress to dish out money, because they have an indirect, backdoor quality. But make no mistake: If you cut Exxon-Mobil’s taxes by $100 million, the effect is exactly the same as writing a check – the oil company is richer and the government poorer.

So when free-market advocates say we shouldn’t be picking favorites by extending tax credits to emerging energy technologies like wind power, we should bear in mind that our government has already picked Big Oil as a favorite, with obscure deductions for “intangible drilling costs,” “tertiary injectants” and the “percentage depletion allowance” that might as well be handouts every year, straight from our taxpayer pockets to theirs.

Back in March of 2012, the U.S. Senate briefly took up the Repeal Big Oil Tax Subsidies Act. That bill, sponsored by Sen. Robert Menendez of New Jersey, would have ended the subsidies of nearly $5 billion per year that our biggest oil companies are enjoying even as they pocket massive profits in this era of $100-per-barrel oil and $4-per-gallon gasoline.

The Senate, voting mainly along partisan lines, failed to muster the 60 votes it needed to move forward on the bill, which also would have extended a critical support for emerging energy technologies, the Production Tax Credit. Over the past decade, Congress has repeatedly allowed the PTC to expire and then renewed it, creating an environment so uncertain that large manufacturers are afraid to tool up new factories to build things like wind turbines. The on-again, off-again nature of the Production Tax Credit is a big reason why, when American firms do build wind farms, they have to use so many European parts.

Against this backdrop of government subsidies for oil, of entirely unconvincing support for renewable energy investment, and of mounting evidence that climate change is a looming crisis created by our use of fossil fuels, a battle has played out now for more than a dozen years over the proposed Cape Wind project on Horseshoe Shoal. With 130 turbines, each of them 440 feet high, the project would send up to 420 megawatts of electricity into the Cape Cod power grid.

Depending on whether you read Cape Wind’s website or the pronouncements of their primary opponents, the Alliance to Protect Nantucket Sound, the Horseshoe Shoal wind project promises either to “gracefully harness the wind” while reducing greenhouse gas emissions by 734,000 tons per year, or to desecrate the Sound’s pristine environment with a noxious industrial development.

The Alliance, with lavish backing from Bill Koch, the multi-billionaire who makes his money in the fossil fuel business, has thrown every argument it can think of at the Cape Wind project over the past decade, from manipulated images that exaggerated the view of the turbines from shore to Native American protestations that the shoal is sacred ground. Most recently, the Alliance has seized upon an argument most of us would agree is more reasonable: that the cost of the energy Cape Wind proposes to supply is simply too high.

Now, I’m not convinced that Cape Wind is the right project in the right place, but I am sure that as we move toward the day when our energy comes from clean sources, we have to be prepared to pay more — especially in these early years as fledgling technologies mature. And I am sure we need to remember that fossil fuels, however cheap they might seem today, come with the hidden costs of environmental damage that our children and grandchildren will someday have to pay.

Sam Feldman of Chilmark, a man whose energy and initiative I greatly admire, once told me that one of his guiding principles is “ready, fire, aim.” Rather than analyze everything to death, he said, he prefers to get right to work: throw a solution out there and improve it as you go along. I recall his principle in the context of Cape Wind because the story of this project is the absolute antithesis of Mr. Feldman’s philosophy – it’s more a case of “ready, aim, aim, aim.”

In my reference room at the Edgartown Library is a shelf groaning with studies of the Cape Wind project that must weigh close to 20 pounds. The vetting this project has been subjected to at state and federal levels is equaled only by the quantity of lawsuits, many of them frivolous, that the Alliance and other groups have launched against Cape Wind.

When Commonwealth Magazine interviewed Bill Koch in February, asking him about his strategies for stopping Cape Wind, he said: “One is to just delay, delay, delay, which we’re doing. . . The other way is to elect politicians who understand how foolhardy alternative energy is.”

His paid mouthpiece, Audra Parker of the Alliance, naturally puts things in a greener, more palatable way, declaring: “We support renewable energy including offshore wind, but appropriately sited and without being an excessive burden to ratepayers.”

In the end, if the Cape Wind turbine project ends up not being built, I won’t be crying bitter tears of disappointment. I certainly won’t be joining in the opponents’ victory parties. However this story plays out, we’ll look back on it someday as a lesson in how difficult it was to change our ways of thinking about energy, and as an example of how hard the old-guard magnates of fossil fuel fought to protect their status quo.

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Across the street from our place in Edgartown, our neighbors have built a small guest house. This summer they moved into it for July and August, renting their main house to vacationing families by the week. That move, I think, is emblematic of the displacement all of us in the Island’s year-round community feel to some extent when summer’s influx hits.

The stresses of the high season involve more than the mere contrast between our winter population of 16,000 and summer’s quadrupling of that number. The starkest contrast of all is between the lives of the year-rounders who struggle to earn their money during the busy season and the seasonal visitors whose wealth is so great that they’ve lost all connection with the daily drama of a dollar less, a dollar more. For them the numbers have become an abstraction, just a way of keeping score.

They come here to unwind, but sometimes the quest for relaxation is complicated by the impatience that accompanies great wealth. When you have more money than you could ever spend, it seems unfair, somehow, to be stuck in the same traffic jams and long lines at the supermarket and post office that everyone else has to live with. Time, for the wealthy, becomes the most precious commodity, and so each summer we observe the spectacle of tailgating, tightly-wound vacationers in a hurry to get somewhere and relax.

Years ago a friend returned to her house after renting it out for August and found that a favorite oriental rug was missing from the living room floor. She frantically called her rental agent, who contacted the renters. “Oh, the children tracked sand on that rug so we took it to the dump,” they said. “Please just replace it and send us the bill.”

This is how the calculus of time versus money plays out when you have so much of the latter, it’s easier to replace an heirloom rug than to vacuum it. And in fact, that last bit of instruction from the wealthy renters was truer than they probably realized. In myriad ways, this has become the dynamic that shapes the relationship between the Vineyard’s year-round and summer communities: We send them the bill.

Enrollment in our public schools, which has been dropping steadily as year-round families give up trying to make ends meet on the Vineyard, stands somewhere around the 2,100 mark this fall. Altogether, our six Island towns will spend well over $50 million delivering a year of education to these students, which puts the average expenditure per pupil at more than $20,000.

Our per-pupil spending on public education is among the highest in the state, and yet property tax rates on the Island are among the state’s lowest. How do we accomplish this? Again, quite simply: We send them the bill.

On this Island where food pantries run year-round and the homeless count hovers consistently at more than 100 people, we enjoy the services of a modern hospital built with nearly $50 million in private contributions, a new $12-million YMCA, and more than 3,000 acres of Land Bank sanctuaries bought with fees charged on sales of the Island’s outrageously expensive real estate. The same seasonal residents whose wealth has driven the cost of a working family’s house far beyond a working family’s reach are investing heavily in the quality of Island life each year, not just with their property tax dollars but also with their charitable giving.

I’ve been told that the Navy, when training its submariners, places special emphasis on the social skills necessary to get along in cramped quarters – you need a lot of “excuse-me’s” when squeezing past each other in tiny passageways, and when each bunk is shared in eight-hour shifts. That sounds like the sort of training we could use for summer on Martha’s Vineyard. By late August, it’s hard for most of us to remember how much the summer people contribute that’s positive – not least of which is purchasing nearly two-thirds of all the goods and services sold here, by the estimate of the Martha’s Vineyard Commission.

The bright idea in economic circles, for more than half a century, has been to build up the Island’s shoulder seasons. The Martha’s Vineyard Striped Bass and Bluefish Derby, which starts a week from Sunday, was launched in 1946 with just that goal in mind. The derby is one of the Island’s great fall traditions now, but in early September it’s hard to be upset that efforts to boost this shoulder season have gone only so far. Our summer population does so many things that benefit the Island, and one of the most wonderful things they do each September is leave.