Crime, like health, can go in cycles. Certain factors (poverty, lack of education, etc.) start ripple effects that create and then worsen problems. But we also can reverse cycles in health and crime.
More importantly, the two are not separate. Another post in this forum, from Lenore Anderson of Californians for Safety and Justice, explains how counties can provide care to people in jail who need mental health or substance abuse services to stop cycles of crime.
Stopping those crimes doesn’t just prevent victimization of individuals but actually has a direct correlation to health outcomes in entire communities fraught with violence, drug abuse and mental illness.
First, it’s important to recognize how experiencing violence negatively affects the health of those exposed to it. Take for example, San Francisco’s Bayview Hunters Point neighborhood, which has high rates of poverty and violence.
Last year, as part of my work at the California Pacific Medical Center Bayview Child Health Center, I joined Stanford psychiatrist Victor Carrion to conduct a study that analyzed the records of 701 children treated at the health clinic. Of those, two out of three had experienced some level of adversity (exposure to violence, substance abuse, etc.). Those experiencing higher levels were twice as likely to be overweight or obese, and 30 times as likely to show learning and behavior problems as those who had not.
These findings confirm previous studies on the impact of early adversity on brain development and the body. When facing a threatening or scary situation, the body releases stress hormones like adrenaline and cortisol that quicken the heart rate and increase blood pressure. Stress responses also decrease activity in parts of the brain responsible for impulse control and judgment, while stimulating inflammation by the immune system. Children repeatedly exposed to household or community stressors can experience long-term learning and health problems.
The 1998 Adverse Childhood Experiences Study of 17,000 adults found that those exposed to four or more adverse experiences in childhood had increased risk of adult diseases like heart disease, hepatitis and cancer.
Too often people living in communities exposed to violence cannot access care because they can’t afford insurance. Enter the ACA.
In addition to expanding coverage, the ACA also increases reimbursements for case management, preventive services and the creation of a primary care “home.” All this translates into more individualized attention for people who need to break cycles of drug abuse and mental health struggles.
Ultimately, this new focus on individuals and a continuum of care benefits entire communities, since each life that is improved builds a healthier cycle of behavior and well-being that can reverse negative trends in our neediest neighborhoods.