Category Archives: Consequences of Violence

The Impacts of Housing Policy on Socioeconomic Residential Segregation and Violence

We are increasingly being made aware of how important our environment is to all aspects of life (health, emotional well-being, access to education, opportunity, etc.) however, many don’t realize how housing policies in our country have had such a large impact on poverty, education, health and violence. Urban planning and housing policy is intimately tied to all aspects of violence prevalent in our communities. In turn, the physical environments that people live in define not only their educational and employment opportunities, but also their health outcomes. I was specifically interested in finding out how housing policies and programs that were implemented right after World War II shaped the characteristics of neighborhoods and the geographical divisions within cities that exist today.

In 1934 following the Great Depression, the federal banking system was restructured and the Federal Housing Administration (FHA) was created as part of a new deal program in order to help citizens purchase homes by privately lending money to home buyers. The FHA also allowed the government to control who could or could not purchase homes based on a variety of factors that more often than not included race as a criteria used to deny loans1. Redlining was one such practice induced by the FHA in order to prevent African Americans and other minorities from obtaining housing loans. In 1935, the FHA and the Home Owner’s Loan Corporation (HOLC) assessed 239 cities and created residential security maps, which were meant to outline economic and social stability, but in reality outlined neighborhoods on the basis of ethnic make-up. Based on these maps, many minority communities were ineligible for housing financing and were denied housing loans. Politically motivated practices such as redlining in predominantly Black and minority occupied neighborhoods created a “lack of equal access to credit, [which] had profound ramifications including fabulous enrichment for speculative contract sellers and their investors, debt peonage or impoverishment from many black contract buyers and an almost guaranteed decay of the communities in which such sales were concentrated2.”

Up until the 1960s, “federal housing agencies engaged in racial redlining, refusing to guarantee mortgages in inner city neighborhoods3.” The long-term effect of practices such as redlining included the separation of populations along ethnic lines, creating a sort of ‘urban apartheid,’ that can be directly traced back to the above government policies. Housing policy must be designed to address this history of spatial and racial socioeconomic segregation. One avenue through which this can be addressed is through mixed income housing that encourages socioeconomic integration of neighborhoods. An interesting example that we recently discussed in our class on violence was the preservation of socioeconomic integration of neighborhoods in Paris. A lack of elevators in many buildings in Paris led naturally to a social order where wealthy people lived on the ground floor (because they could afford a more expensive apartment where they didn’t need to climb the stairs), and poorer families lived on the higher floors (because they could not afford the more expensive apartments on the ground floors). As a result of this natural preservation of socioeconomic integration (simply due to lack of elevators), school systems in Parisian neighborhoods remain socioeconomically integrated, presenting equal opportunities for wealthy as well as poorer families.

An understanding of the historical forces that have instilled a legacy of racism and spatial segregation is key to moving forward with the structural changes that must be implemented to improve living conditions in zones of concentrated violence and inequality. Acknowledging the cumulative impact of years of politically motivated spatial segregation and installation of inequality is essential both at the level of public knowledge and governmental policy decision making. While much of the impacts of historical housing policy seem lacking in hope for change and progress, an important aspect to note is that the pride and sense of connection to a community can be extremely impactful on health including on levels of violence. Studies demonstrate that the health of new immigrant populations is often on equal levels as those of wealth Americans based on the fact that recent immigrants maintain strong connections and ties to their community. These positive health effects rapidly drop off in second and third generation immigrants. These studies offer promising avenues of hope, suggesting that strong family and community networks can counter many of the most difficult situations that people face and greatly affect an individuals’ resiliency to future insults. Thus, important interventions should not only include changes in housing policy that would promote socioeconomic integration of neighborhoods, and programs that would allow individuals to own their own homes, but should also include programs that foster a greater sense of community and increase ties and connections individuals feel towards their community.

 

1Ploys in the Hood, Raymond Arsenault

http://www.nytimes.com/2009/03/22/books/review/Arsenault-t.html?_r=0

2Why the Poor Stay Poor, Richard Thompson Ford

http://www.nytimes.com/2009/03/08/books/review/Ford-t.html?pagewanted=all

3 In Chicago, Real Estate and Race as a Volatile Mix, Dwight Garner

http://www.nytimes.com/2009/03/18/books/18garn.html

 

The Necessity of Understanding the Intangible Costs of Violence against Women

While violence against women is widespread world-wide and within the United States, I was recently surprised to discover that when measuring the cost of violence in an economic sense, the economic value of women is far less than that of men1. The next question to ask is – how exactly is “economic value” measured? One method, the human capitol approach, measures value in terms of participation in the labor market and wages earned. In this analysis, women, the elderly, and children are all assigned values less than that of men based on the fact that these groups earn lower wages on average and also have decreased overall participation and representation in the labor market. These measures however, are all intimately tied to “economic monetary value” and do not consider or take into account measures going beyond those directly related to the labor market.

A UN report on violence against women in 2005 addressed the need for expanding the ways in which economic value/cost is assessed2. The report separated the types of costs of violence against women into four different categories: direct tangible costs, indirect tangible costs, direct intangible costs and indirect intangible costs. Direct tangible costs include aspects that are typically assessed in cost measurement analyses including expenses paid and spent assessed by “measuring the goods and services consumed and multiplying by their unit cost.” Indirect tangible costs are also typically included in economic analyses and are typically measured as a loss of potential – including earnings and profits that would result from reduced productivity or loss of personal income due to decreased time at work. Usually these direct and indirect tangible costs have obvious monetary value that can be assessed through traditional means of economic analysis. The last two cost categories, indirect and direct intangible costs, however, present more difficult cost categories to measure. Indirect intangible costs “result indirectly from the violence, and have no monetary value” (in the traditional economic analysis sense), and can include the pain and suffering experienced by the woman and a resultant decreased overall quality of life. The indirect intangible costs also have no monetary value, but instead result indirectly from the violence, and can include the “negative psychological effects on children who witness violence,” or the decreased care a mother can provide after herself experiencing a traumatic or violent event. These indirect intangible costs are perhaps the least explored of the four cost categories. Recent evidence on the impacts of adverse early life environments on children would suggest that the indirect intangible cost category is perhaps the most biologically, socially and economically relevant category and thus necessitates further study and consideration.

In general, societal costs are dual-sided, with one side reflecting an analysis of economic changes related to monetary value, and the second side involving social consequences that may not be as easily measured. In particular when considering the cost of violence against women, the second societal cost, which includes health costs and effects on dependents of women affected by the violence indirectly, is not easily measured. In an early class discussion this semester on the biological bases and effects of violence, we discussed research demonstrating that women are often more prone to internalizing behaviors that can result in the development of and increased risk for psychiatric disorders such as posttraumatic stress disorder (PTSD), while men often exhibit externalizing behaviors following violence or traumatic experiences (such as aggression, violent behavior and crime). In fact, women are more likely to develop PTSD following an experience of trauma compared to men3. Understanding the biology behind these differences in susceptibility to PTSD development is of extreme importance.

In addition to the direct effects of violence on the woman, we must also consider the dependents (children, etc.) that are just as affected by the woman’s experience of violence. In fact, research has demonstrated that women experiencing domestic violence before becoming pregnant, have children who exhibit characteristics of children living in households with domestic violence, even if those children have been raised in safe environments4. There are several explanations for this phenomenon – biological factors and epigenetic mechanisms that occur in the mother as a result of experiencing extreme stress in the form of domestic violence may be passed on and predispose the child to having an increased risk for anxiety disorders and PTSD (see the recent blog post on transgenerational inheritance for more information). Additionally, the woman could continue to suffer from the traumatic experience and behaviorally develop a different mode of maternal care due to her increased stress, anxiety and depression, which can also adversely affect the developing child.

These intangible costs of violence against women represent huge potential cost categories both socially and economically. We must push to develop tools to document and measure the effects of violence against women on the second and third generation offspring. Biological research has shown that traumatic experiences in parental generations can be biologically transmitted/inherited by the offspring, and that these effects persist for several generations. We must enhance our sphere of understanding by developing ways to economically document these effects.

1Corso, P. S., Mercy, J. A., Simon, T. R., Finkelstein, E. A., & Miller, T. R. (2007). Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. American Journal of Preventive Medicine, 32(6), 474–482.

2Day, T., McKenna, K., Bowlus, A. (2005). The economic costs of violence against women: an evaluation of the literature – Expert brief compiled in preparation for the Secretary-General’s in-depth study on all forms of violence against women. http://www.un.org/womenwatch/daw/vaw/expert%20brief%20costs.pdf

3Breslau, N. (2001). The epidemiology of posttraumatic stress disorder: what is the extent of the problem? Journal of Clinical Psychiatry, 62(17), 16-22.

Transgenerational Inheritance: The Impact of the Environment on Future Generations

Our class on violence recently explored ideas within developmental psychology that understanding the contexts within which the child develops is crucial for studying child development. The child develops in multiple embedded systems, each of which is unique and incredibly complex. These range from immediate contexts (family life, within a neighborhood and community) to secondarily related (the parent’s work environment, schools) and finally to broader economic, political and historical contexts.  The child exists, navigates and acts within all of these spheres simultaneously. Recent research has demonstrated that environmental events within each of these spheres can permanently alter an individuals ‘epigenetic code.’1 This further highlights that a child’s environment can leave a lasting and permanent effect at the level of biology and behavior.

Modern epigenetics can be defined as ‘the structural adaptation of chromosomal regions so as to register, signal or perpetuate altered activity states’2. The most prominent epigenetic mechanisms include DNA methylation (modification of the DNA through the addition of a methyl group) and histone acetylation (modifications of adding an acetyl group to the protein histones, in which the DNA is usually wrapped). Generally, methylation switches genes off and acetylation switches them on. Factors within the environment can influence these mechanisms, which together can change the way genes are turned on or off. In addition to altering the epigenetic code in ways that affect an individual across the lifespan, recent evidence has demonstrated that the epigenetic code acquired throughout life may be inherited – theoretically providing an adaptive advantage for the offspring in preparing them for their future interactions with the world.

Thus in addition to the broader social contexts initially discussed we must also consider 1) post-natal behavioral and social interactions between the parent and the offspring that can impact the epigenetic code, 2) prenatal life involving fetal programming (environmental factors during pregnancy that may influence the fetus and affect its development) and finally, 3) pre-conception contexts (the impact of the parental and grand-parental environment that may be inherited through the epigenetic code). At all three of these levels the epigenetic code may be altered.

While post-natal behavioral and social interactions and fetal programming have received much attention in recent years, the idea that a ‘pre-conception’ environment may influence the health and susceptibility to disease of the offspring has received less attention. A recent study in rodent animal models investigated the intergenerational effects of nicotine and found that in pregnant rats exposed to nicotine, the offspring and the ‘grand-offspring’ develop the same asthma induced by nicotine3. Studies in humans related to nutrition and diet have found that grand-parental food supply is associated with mortality risk, cardiovascular disease and diabetes in the grand-children (even if the grand-children and their parents had a healthy diet and nutrition)4.  Diet, environmental toxicants, drugs and particularly stress have the ability to severely impact an individual, and now it seems, to also impact their offspring and grand-offspring.

Stressful conditions and negative environmental factors such as exposure to traumatic or violent events can affect brain functions and mental health throughout life, and we are only beginning to understand how the impacts of these stressors may be transgenerationally passed on to future generations. These data all highlight the critical need for understanding the multiple and complex contexts (both immediate and indirect) within which a child develops.

1Franklin TB, Mansuy IM (2010). Epigenetic Inheritance in mammals: evidence for the impact of adverse environmental effects. Neurobiology of disease 39(1):61-65.

2Bird A (2007). Perceptions of epigenetics. Nature 447: 396-398.

3http://www.economist.com/news/science-and-technology/21565573-some-effects-smoking-may-be-passed-grandmother

4Pembrey ME, Bygren LO, Kaati G, Edvinsson S, Northstone K, Sjostrom M et al (2006). Sex-specific, male-line transgenerational responses in humans. Eur J Hum Genet 14: 159-166.

Link

This week many topics were discussed in our Violence class. I have chosen to focus on Dr. Abigail Hankin’s lecture and specifically on child abuse and neglect, domestic violence, and elder abuse.

Child Abuse and Neglect
Child abuse is rampant. Approximately 2-3% of children suffer abuse or neglect every year which results 1000-2000 deaths. An estimated 80% of child abuse and neglect victims are under 4 years old and 40% of the victims are under 12 months old. Children who have behavior problems or special needs are more likely to be abused. Often the abuser is someone who is a caregiver to the child but not related by blood. Caregivers who have inappropriate expectations of the child, have a mental health history, and substance abuse are more likely to abuse a child. One way that these individuals become caregivers is dating the parent of the child. Child abuse includes physical abuse, sexual abuse, and psychological maltreatment. Physical abuse includes shaking, slapping, punching, beating, kicking, burning and biting. Neglect is when a caretaker does something or fails to do something that results in harm. Often neglect is a failure to meet basic needs of food, shelter, medical care and education.

Victims of child abuse are more likely to be involved in aggressive and violent behavior later in life. Child sexual abuse also has been linked to suicidal behavior. (Krug, 1084). Other consequences of child abuse and neglect include increased aggression with peers, difficulty forming friends, increased rates of depression, anxiety, and substance abuse. (Krug, 1084).

Domestic Violence (aka Intimate Partner Abuse)
Domestic violence is very common. It is often cyclical with stages of tension building up, battering, and the honeymoon phase. The honeymoon phase typically involves the abuser apologizing and saying it will never happen again and how much he or she loves the victim. Then the tension builds again and the cycle repeats. For example, Kansas City Chief player Jovan Belcher shot and killed his girlfriend who was the mother of his three month old child before taking his own life. Other examples include the ongoing saga between Chris Brown and Rhiana, Madonna and Sean Penn, Tina Turner and Ike Turner, Whitney Houston and Bobby Brown, Mariah Carey and Tommy Mottola, Pamela Anderson and Tommy Lee.

http://www.thedailybeast.com/galleries/2010/12/04/celebrity-domestic-violence.html#slide1

Individuals highest at risk of being a victim are women who are divorced, separated, or single, economically distressed, and pregnant women. Those highest at risk of being an abuser include people who have recently lost their jobs, abuse drugs, and are jealous or possessive. People often ask or don’t understand why the victim of domestic violence don’t pick up and leave the abuser. These victims might stay because they believe the abuser will change or didn’t mean to hurt them or out of love for the abuser. Fear also induces individuals to stay in an abusive relationship. Victims may not disclose the abuse out of fear, shame, or abuser threats.

Elder Abuse
Not all types of abuse are physical (or purely physical). While approximately 2-10% of elderly people are victims of abuse, 80% of elder abuse cases go unreported.

Examples of Elder Abuse
A Duluth woman lost her home and all her money when one of her sons stole close to $400,000. Investigators said her son gave himself power of attorney allowing him access to the funds.

http://www.wsbtv.com/news/news/local/family-speaks-out-after-mother-becomes-victim-elde/nWJg4/

A Dekalb woman was sentenced to 20 years in prison for exploiting elderly and disabled adults she was caring for. The elderly and disabled were housed in unsafe and unsanitary conditions. They did not get adequate food and medication.

http://www.ajc.com/news/news/woman-gets-30-years-for-exploiting-elderly-disable/nWZPX/

Information from this post comes from a lecture given by Abigail Hankin on February 25, 2013 at Emory, articles linked within the post, class notes from my Child Welfare Law and Policy course, The World Report on Violence and Health by Etienne G. Krug, James A. Mercy, Linda L. Dahlberg, Anthony B. Zwi published in The Lancet Vol. 360, October 5, 2002. Evolution of the Dependency Component of the Juvenile Court by Marvin Ventrell (1998).

The Interrupters

Abigail Hankin mentioned the documentary The Interrupters which portrays those trying to stop youth violence on the streets of Chicago. Many of the Violence Interrupters are former violent offenders and gang members or leaders themselves. Below is a link to the full documentary.

http://www.pbs.org/wgbh/pages/frontline/interrupters/

This American Life

For another taste of youth violence in Chicago check out the This American Life episodes below. The radio crew spent five months at Harper High School in Chicago. Last year 29 current and recent students of Harper were shot. The show chronicles the lives of students and administrators surviving the gun violence. The story is told in two parts.
http://www.thisamericanlife.org/radio-archives/episode/487/harper-high-school-part-one

http://www.thisamericanlife.org/radio-archives/episode/488/harper-high-school-part-two

The Psychological Trauma of Death Row

On the evening of February 19, 2013, Warren Hill, a Georgia inmate said his final goodbyes and prepared to die by lethal injection.  Just 30 minutes before the time he was scheduled to be executed, after he had already taken an oral sedative to prepare for the gurney, Hill learned of a stay on his execution issued by the 11th circuit federal appeals court.  This was not the first time Hill had been forced to face his death, only to be temporarily saved within hours prior. In July, he received a stay on his execution just 90 minutes before the scheduled injection.

This time, Hill’s stay was issued on account of new questions surrounding his intellectual disability and the testimonies of his psychiatric examiners.

While Hill’s case raises many questions about intellectual disabilities and the justice system, it also illuminates the psychological trauma perpetuated by death penalty systems.  It is no secret that our bodies bear the marks of psychological trauma in many ways.  We now know the many ways in which bodies and minds bear the marks of trauma long after the event itself (Robyn Fivush, et. al).  However, in public dialogue, death row inmates are an exception, as few people attempt to understand them as victims of a certain type of trauma themselves.  For many, the fact that death row inmates are destined for execution precludes any attempt to understand and provide therapy for the psychological trauma caused by death row procedures, particularly in terms of appeal and stay processes.

In a 2004 study issued by Cornell, researchers found that 1 in 8 of individuals executed under the death penalty in the modern era voluntarily waved the appeals process and faced their executions.  Human rights advocacy groups, such as the Southern Center for Human Rights and Amnesty US point out that many inmates would rather voluntarily choose to face their death rather than prolong the anxiety of the stay process by way of an appeal. Some even liken Hill’s recent stay, as well as those in other death penalty cases, as akin to psychological torture. While, for death penalty activists, stays can be a minor victory in that they prolong the inmate’s life, they can also serve as the one of the most psychologically damaging experiences that an inmate can suffer. However, very little research and exploration has been done in this area, as death row inmates are typically cast as “unrecoverable”. In the rare case that an inmate receives a stay and is proven innocent, psychologists such as Stuart Grassian point out that the effects of the trauma are nearly irreversible.

How might psychologists work therapeutically with death row inmates, who face the psychological trauma of execution every day? How might such approaches appropriate practices such as narrative therapy, virtual memory, and support groups? Moreover, would such practices be helpful in a context where the prospect for recovery seems so bleak? In fact, psychologists across the nation are beginning to discover the positive, (re)humanizing effects of group counseling therapy with condemned inmates.

Perhaps the most important question in all of this still stands: Are death row inmates valuable enough as human beings for their psychological trauma to be taken seriously?

The Economic Impact of Domestic Violence

This past week in “Violence- A multidisciplinary Inquiry,” guest lecturer Phaedra Corso discussed the cost of violence. Looking beyond the obvious lost of a life, Corso encouraged the class to consider the economic impacts of violence. In my previous post on religion and violence, I focus on religious justification for intimate partner violence. As a Women’s, Gender and Sexuality Studies major, I am more inclined to consider the feminist perspective on issues, and this blog is no exception.

The effects of intimate partner violence (IPV) in regards to the psychological and physical burdens on the victims and surrounding children are immense. However, considering Corso’s lecture, I was intrigued to think beyond those immediate outcomes. I began to question the consequences  of IPV on the broader population. A BBC news article gave me the numbers I was looking for while also acknowledging that the accurateness of these statistics is difficult to measure.

One of the primary points made in the article is that violence against young girls and women is more than a public health issue because it is suspected significantly decline economic growth.

… a study by UN Women looked not only at women’s loss of earnings, and out of pocket expenses – for medical treatment, police support, legal aid, counselling and judicial support – but also at lost school fees, with children missing school due to the violence inflicted on their mothers. The cost? Nearly 1.4% of Vietnam’s GDP.

This statement emphasizes the importance of the proper use OF public education funds. Domestic violence not only affects these families by limiting their children’s education, but also by limiting the effectiveness of the system of education itself. This may seem trivial when considering only one student missing class, but consider an extreme.  What if every child in one class missed school on the same day for one reason or another. The amount of money going into paying the teacher, principle, electricity bills, water bills, and other finances related to schooling would be wasted. Though absence of all students is more than likely not the case, it is important to consider the funds wasted when a child chronically misses school due to the violent climate in their home.

Direct medical costs plus productivity losses amounted to between 1.6% and 2% of gross domestic product annually – that’s about the average annual public spending on primary education in a range of developing countries.

This statistic highlights the loss of economic potential for children who would have benefited from those funds towards primary education.  We see here then that domestic violence does not only affect the children who witness the altercations, but children who are completely ignorant to the violent situation as well.

The long-term economic impacts discussed in the article primarily discuss the “Cycle of Abuse.” That is, a child who witnesses intimate partner violence is on average 2 to 3 times more likely to either become a perpetrator or victim in their own relationships, which yields a repeat of the same economic devastation that we’ve already discussed. Another important long-term economic impact is the correlation between domestic violence and terminal illness.

American children from a violent home are two to three times more likely to suffer from cancer, a stroke or heart disease and five to 10 times more likely to abuse alcohol.

With this is mind, the economic impact on the healthcare system cannot be completely isolated from the economic impact on education in regards to domestic violence. The article finishes with several ways to heal our broken system and end domestic violence. I simply want to encourage readers of this blog to resist the urge to mind your own business when you suspect domestic violence/intimate partner violence. Consider the victims in the home, the victims in the school, and yourself. Where do you fit into this system that is economically affected by domestic violence?

http://www.bbc.co.uk/news/business-21696469

Economics Behind Violence

            The focus of the class this week was the relationship between violence and economics. The lecture speaker, Dr. Phaedra Corso, emphasized the economic implications that occur as a result of violence. This type of information was cited as being significant for policy-makers in public health, law enforcement, etc. because it allows these individuals to assess tangible data in order to formulate a large-scale response. For example, if hospital data shows a noticeably high rate of domestic violence patients, programs can be put into place in order to raise awareness about resources for abuse victims.
            This discussion reminded me of Dr. Robert Agnew’s lecture on strain theory and the social causes that lead to violent behavior. To paraphrase, strain theory holds that stress/stressors cause individuals to react negatively and may lead to violent crime. Also during this lecture, the idea of social control and social disorganization was discussed. Violence, it is held, can result from the loss of social control mechanisms, such as fear of punishment and positive family environments.
            Economics, in my opinion, has an important role in the discussion regarding these two theories. Although Dr. Corso focused on the economic effects of violence, there is also room for serious research and discussion about the economic motivators that lead to violent behavior. This idea encompasses many forms of violence, from war to interpersonal and self-directed violence. While not absolute, there seems to be a clear connection between economic difficulty and high rates of crime and violent behavior.
            There is a particularly direct relationship between poverty and crime. Gary Becker, the influential economist, is known for his idea (1968) that people resort to crime if the costs of committing the crime are lower than the possible benefits. Following this logic, people who live in poverty have a much lower cost/benefit ratio than those individuals who are not in poverty and, thus, have more to lose. Lack of education, unemployment, poor living conditions, drug use, and dangerous environments are all associated with poverty, and each of these factors is also linked with crime.
            This is an important relationship to consider because the economic aspect behind violent behavior helps perpetuate violence in low-income regions, from housing projects in urban American cities to the slums of developing countries. In fact, scholars and experts following this logic have designed responses that incorporate components of poverty, such as this study by J. Gilligan in which education of violent inmates is the primary suggestion for violence reduction. Ultimately, in order to successfully develop and institute programs that decrease violence and rehabilitate victims and communities, the economic situation must be considered, both as a result of and a reason for violent behavior.