Lead poisoning and violent crime

Well, it's been way too long since I've updated this blog, but with all the furor about lead and it's potential link to violent crime lately, I thought I'd weigh in.

It's an eye-opening correlation- we know that living in poverty in urban centers is correlated with long-term vulnerabilities to diseases like diabetes and high blood pressure.  Certainly the exposure to toxins is higher, and the effects of that are still unknown.  But this article takes the research further and proposes that lead exposure early in life is directly related to violent crime.  It's a juicy hypothesis, and the kind of issue that people clamor to get behind, if for no other reason that it provides a (seemingly) simple solution to a complex problem.

But there are issues with this.  For one, correlation does not equal causation.  Other issues with the research are spelled out in this well-written piece by Scott Firestone.

Violent crime doesn't just happen when someone's frontal lobes are impaired due to toxin exposure.  And there are many other elements of life as a young black man in the inner city that contribute to the high rate of incarceration (a link made in a different Mother Jones article, here).
A quote:
Both gasoline lead and lead paint were most prevalent in the postwar era in the inner core of big cities, the former because that's where cars were densest and the latter because slumlords had little incentive to clean up old buildings. Because African-Americans were disproportionately represented in inner-city populations during the high-lead era, they were disproportionately exposed to lead as children. The result was higher rates of violent crime when black kids grew up in the 70s and 80s. 

If this furor sparks concern and outrage about toxins in the inner city poisoning our children, and if that concern and outrage is channeled into real, on the ground work to clean up those environments, great.  But let's not claim the solution to racial inequity in this country is lead reduction.  Saying that lead poisoning essentially created a hoard of brain-damaged young black children who then went on crime sprees is a step away from eugenic thinking.  Explaining away the 'fact' that black children are just a bit slower than white children due to blood poisoning, and therefore more likely to break the law ignores too many of the other aspects of life in the inner city that might contribute to crime.

Let's talk about institutionalized racism, about poverty, about stress.  Broken families.  Access to health care and quality schools.  Nutrition.  Growing up in the midst of violence.

Certainly poisoning in early childhood is an awful, awful problem that has a clear solution.  And I'm glad to see this debate shining a light on that problem.  So how about we do something about the lead problem and then move on to tackle the bigger issues?

Gabor Mate: On the health effects of an isolated society

I heard a portion of one of Dr. Mate's lectures on the radio this morning and was pumping my fist in excitement.  Here's one of the only voices linking early experiences and stress/trauma to later pathology such as cancer and addiction, but tying all of this together with a critique of capitalism and society.  He stressed (hah) over and over how impossible it is to separate the mind from the body, and the individual from their social context.  While I'd like to take a closer look at the research he uses to support his claims (such as that Native Americans had significantly lower rates of addiction before the European conquest, although they had access to many addictive substances, as though there were people measuring rates of addiction in Pre-Columbus America), I love that he challenges us to think about the social aspects of disease in terms of justice, inequality, and infant mental health. 

Here's his wikipedia article below:

http://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician)

 

And here is a link to some of his interviews:

http://www.democracynow.org/2010/12/24/dr_gabor_mat_on_the_stress

One Day in Iraq

I found this video while researching my paper.  It beautifully illustrates two important concepts: issue framing and the completely F***ED up priorities our nation has when it comes to where to invest money.

By the way, it was created by a Quaker group that supports human rights.  Go Quakers!

Crafting efficient early intervention programs

Photo credit: Tony Tran

I stumbled on the website for Harvard's Center on the Developing Child while researching my paper and discovered an incredible resource within it.  One of the initiatives they are working on is a meta-analysis of efficacy in early intervention programs.  We've frequently discussed whether or not early intervention or programs such as Head Start/Early Head Start are effective over the long run.  The results of studies have indicated that, in large part, it depends on the program.  Blanket judgments such as "early intervention cannot give children long-term gains in development" are invalid due to the wide variety in program quality.  This initiative seeks to learn what makes a quality program, and how to help programs increase the quality of their care.

They have identified 5 factors:

1.  Small group sizes and high adult : child ratios
2.  Qualified and well-compensated personel
3.  Warm and responsive adult-child interactions
4.  A language-rich environment
5.  Safe physical environment

They have also identified 3 layers of programs to most effectively serve children living in different life conditions:

1.  General health and childcare (for all children)
2.  More broadly supportive programs for low-income families
3.  Targeted, more intensive interventions for children living with 'toxic stress' (drug exposure, foster care system, physical or sexual abuse, violent neighborhoods)

Here is a link to a video that explains this study.

Adverse Childhood Experiences Study

This is the study I mentioned in my last post.  It is such a strong testament to the necessity of infant mental health work in the field.  If nothing else, there exists an economic argument in terms of savings through preventative care.  If early childhood traumas are not addressed, the outcome usually involves multiple, chronic diseases and conditions.

Check out this PDF for a brief, easy to read summary of the work that this study has done and some economic costs of ignoring this issue.

From the ACE website:

What is the ACE Study?
The ACE Study is an ongoing collaboration between the Centers for Disease Control and 
Prevention and Kaiser Permanente.  Led by Co-principal Investigators Robert F. Anda, MD, 
MS, and Vincent J. Felitti, MD, the ACE Study is perhaps the largest scientific research study 
of its kind, analyzing the relationship between multiple categories of childhood trauma 
(ACEs), and health and behavioral outcomes later in life.


What's an ACE?
Growing up experiencing any of the following conditions in the household prior to age 18:

1. Recurrent physical abuse
   
2. Recurrent emotional abuse
   
3. Contact sexual abuse
   
4. An alcohol and/or drug abuser in the household
   
5. An incarcerated household member
   
6. Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
   
7. Mother is treated violently
   
8. One or no parents
   
9. Emotional or physical neglect

The link between childhood trauma and adult health

My mom had a 'grandma moment' and clipped this article from her New Yorker to send to me.  As I read it, I literally started pumping my fist in the air in excitement.  It's about a pediatric health clinic in San Francisco, in the Bay View/Hunter's Point neighborhood.  The doctor who runs the clinic, Nadine Burke, understands that trauma in early childhood (whether it be from intra-uterine drug exposure, physical abuse, neglect, parental drug use or violence, or life in a series of foster placements) has physical ramifications later in life.  In fact, a longitudinal research project with thousands of participants done by Kaiser found there to be a very strong link between these factors occurring in early childhood and later development of asthma, heart disease, weight problems, depression, increases in risky behaviors, and earlier deaths.

And she is incorporating infant mental health into her medical practice!  Mind Body Awareness, biofeedback, parent-infant psychotherapy, and meditation/yoga classes are all available through this facility.   Check out the article here.  I want to work here!

What makes advocacy for disability rights so effective? Can early intervention learn a lesson here?

We frequently dwell and ruminate on the topic of budget cuts, poorly-written policy, and politicians who just don't seem to listen. Yet budgets keep getting cut, policy changes into yet worse permutations, and politicians still ignore us.  Sometimes, it seems that the early intervention community suffers from learned helplessness.  Yet advocates for disability rights have made tremendous strides in working towards legal and social equity.  What makes their work so effective? And what can those of us who advocate for children's rights learn from this?

Effective advocacy has many layers.

The first begins with education.
Knowing the history of your cause, the facts around your population of interest, who serves them, and where the money comes from makes you an informed advocate.  This is an area where early intervention could do more work, and where the disabilities, AIDS, and homelessness movements have excelled.

The next layer is community wrangling.  Connecting with local people.  Organizing neighbors in your community (with education as a goal), and making connections with others who are advocating in other places.  Examining successful advocacy in other cities and countries is a powerful tool for shaping your own campaign.  And, you know, the reason I'm writing this blog post.

Which leads to my next layer, forming a plan of action.  Effective advocacy has a strategy.  You can base  your strategies on those that have proven effective in the past.

The disabilities movement enlisted people who had the skills necessary to make a difference on a policy level.  I'm talking lawyers, local representatives, and the media.  They got laws passed and funds given.  They did this through inspiring parents of children with disabilities to take action.  They informed people with disabilities of their rights and created advocacy organizations to help fight for those rights when they were impinged upon.  

These are lessons early intervention can learn.  To some degree, these are things we are already working on.  The "Stroll-In for Head Start" created headlines in local news and demonstrated to legislators and senators that people care about early intervention.  And, in the latest round of the budget, Head Start and Early Head Start funds were protected.  But there is more we need to do.