PI's Weekly Media Digest: IG reports on family separation policy, new study links sexual assault and harassment to depression, anxiety, and other health issues later in life

New research published this week by the US Census Bureau, in collaboration with researchers from Harvard and Brown universities, provides a Census-tract level look at community conditions that underlie health and opportunity. “This work, years in the making, seeks to bring the abstract promise of big data to the real lives of children. Across the country, city officials and philanthropists who have dreamed of such a map are planning how to use it. They’re hoping it can help crack open a problem, the persistence of neighborhood disadvantage, that has been resistant to government interventions and good intentions for years… Nationwide, the variation is striking. Children raised in poor families in some neighborhoods of Memphis went on to make just $16,000 a year in their adult households; children from families of similar means living in parts of the Minneapolis suburbs ended up making four times as much… The researchers believe much of this variation is driven by the neighborhoods themselves, not by differences in what brings people to live in them. The more years children spend in a good neighborhood, the greater the benefits they receive. And what matters, the researchers find, is a hyper-local setting: the environment within about half a mile of a child’s home.”

This week, the Department of Homeland Security’s Inspector General released reports on the Trump administration’s family separation policy and conditions inside an immigrant detention center during an unannounced inspection. The review of the family separation policy “found at least 860 migrant children were left in Border Patrol holding cells longer than the 72-hour limit mandated by U.S. courts, with one minor confined for 12 days and another for 25… The investigators describe a poorly coordinated interagency process that left distraught parents with little or no knowledge of their children’s whereabouts… ‘Each step of this manual process is vulnerable to human error, increasing the risk that a child could become lost in the system,’ the report found... Inspectors said they continue to have doubts about the accuracy and reliability of information provided by DHS about the scope of the family separations. In late June, a federal judge ordered the government to reunite more than 2,500 children taken from their parents, but three months later, more than 100 of those minors remain in federal custody. The inspector general’s report also found that U.S. Customs and Border Protection (CBP) restricted the flow of asylum seekers at legal ports of entry and may have inadvertently prompted them to cross illegally. One woman said an officer had turned her away three times, so she crossed illegally.” A report on conditions inside an immigrant detention center in the Los Angeles area during a surprise inspection this spring found that “… guards threw detainees into solitary confinement without hearings, routinely forced them into shackles, and cut off visits with family. Doctors signed off on medical assessments that never happened. Detainees were allowed to hang knotted sheets inside their cells, despite the facility’s extensive history of suicide attempts. And an extraction-happy dentist refused to fill cavities while suggesting detainees floss with threads pulled from their socks.”

A study published this week in JAMA Internal Medicine finds that middle-aged women with a history of sexual assault experienced higher rates of depression, anxiety, and insomnia. Sexual harassment in the workplace was associated with sleep problems and heightened risk factors for heart disease, the leading cause of death for women in the US. "When it comes to sexual harassment or sexual assault, our study shows that lived experiences may have a serious impact on women's health, both mental and physical," said Rebecca Thurston, Ph.D., professor of psychiatry, Pitt School of Medicine and the study's first and senior author. "This is an issue that needs to be tackled with urgency not just in terms of treatment but in terms of prevention." Sexual harassment and sexual assault are highly prevalent experiences among women. An estimated 40 - 75 percent of women in the United States have experienced workplace sexual harassment and more than 1 in 3 women have experienced sexual assault. While both have been linked to poorer health outcomes, previous studies have predominantly used self-reported parameters, which could be biased by mood, memory and health literacy, or these studies have not taken into account factors such as socioeconomic status or medication use. In the current study, Thurston and her colleagues analyzed the association between a history of sexual assault or workplace verbal or physical sexual harassment and physical and mental health parameters such as blood pressure, sleep, mood and anxiety. The analysis was conducted among a group of 304 midlife women between the ages of 40 and 60 who were originally recruited as part of a larger study on association between menopause and cardiovascular health.”

Public debate over Brett Kavanaugh’s fitness to serve as a Supreme Court justice turned the focus on issues of sexual violence and alcohol consumption. “The way Ford’s allegations are handled, then, will help define our national understanding of sexual assault for years to come. Do men enjoy superior standing, a presumption of truth-telling denied to female accusers? Just how seriously does our political system take accusations of sexual assault and violence? Are credible allegations disqualifying for the most significant legal body in the country? ... Feminist philosophers have long argued that sexual violence serves an insidious social purpose. The omnipresence of the threat — the intimate nature of it, the fact that any man could in theory be capable of such acts — serves as a form of intimidation. Behaviors as simple as going out alone at night or staying late at the office become laden with risk. The mere threat of rape, in the background, forces women into certain socially prescribed roles. It serves, in effect, to uphold male dominance…  The best way to understand sexual violence, in [Boston University professor Ann Cudd’s] view, is as a quiet but constant campaign of systemic violence to preserve male privilege. “Violence against women is covert, neither recognized as a systematic war against women by the victims nor by those who would be sympathetic,” she writes. “[Yet] all women act under the shadow of a social threat situation which is, statistically, credible yet tacit. It changes our behavior; it makes acquiesce to limitations on our liberty that men do not have, it alters our sense of what is possible.”” At a campaign rally in Mississippi, President Trump mocked Christine Blasey Ford’s account of being sexually assaulted by Kavanaugh, and portrayed men accused of sexual violence as the real victims. As former classmates disputed Kavanaugh’s characterization of his alcohol consumption and his behavior under the influence, Vox reported on the research linking alcohol and violence, and highlighted potential policies that could mitigate harms associated with alcohol. “Alcohol plays a big role in US violence. The National Council on Alcoholism and Drug Dependence estimated that alcohol is a factor in 40 percent of violent crimes. And the Centers for Disease Control and Prevention calculated that alcohol is a contributor in 47 percent of homicides. Even places where alcohol is sold have been linked to violence. A study published last week by researchers at Johns Hopkins Bloomberg School of Public Health’s Center on Alcohol Marketing and Youth, for example, found that access to alcohol outlets in Baltimore is linked to more violent crime, including homicides, robbery, and sexual assault. Other research has produced similar results around the country…” Potential policies to address some of the harms associated with alcohol consumption and sales include:

• “A higher alcohol tax: A 2010 review of the research in the American Journal of Public Health came out with strong findings: “Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.”
• A minimum price on alcohol: A 2013 review of the research by Tim Stockwell and Gerald Thomas at the Centre for Addictions Research in Canada found that, based on data from Canada, “a 10% increase in average minimum price would result in the region of an 8% reduction in consumption, a 9% reduction in hospital admissions and a 32% reduction in wholly alcohol caused deaths — with further benefits accruing two years later.” Negative side effects, such as people resorting to potentially dangerous bootlegging to get cheaper alcohol, were minimal, the review found.
• Reducing the number of alcohol outlets: A 2009 review published in the American Journal of Preventive Medicine also found that limiting the number of alcohol outlets (such as liquor stores) in an area through, for example, stricter licensing can limit problematic drinking and its dangers. But it also found that going too far can have negative results — by, for instance, causing more car crashes as people take longer drives to outlets and possibly drink before returning home.
• Revoking alcohol offenders’ right to drink: South Dakota’s 24/7 Sobriety programeffectively revokes people’s right to drink if a court deems it necessary after an alcohol-related offense. The program, specifically, monitors offenders through twice-a-day breathalyzer tests or a bracelet that can track blood alcohol level, and jails them for one or two days for each failed test. Studies from the RAND Corporation have linked the program to drops in mortality, DUI arrests, and domestic violence arrests.
• Put state governments in charge of selling alcohol: A 2014 report from RAND concluded that when state governments monopolize alcohol sales through state-run shops, they can keep prices higher, reduce access to youth, and reduce overall levels of use.”

California Governor Jerry Brown signed into law several new gun safety bills, imposing lifetime firearm bans for people convicted of serious domestic violence charges and people who have been hospitalized more than once in one year for mental illness, making it easier for guns to be taken away from people deemed a danger to themselves or others, raising the minimum age for purchasing rifles and shotguns from 18 to 21, and requiring people applying for concealed carry permits to complete at least eight hours of gun safety training and pass a live-fire exam. He vetoed a bill that would have limited people to purchasing no more than one rifle or shotgun in any 30-day period.

Fast food workers across the Midwest have been on strike this week, calling for union rights and a $15 minimum wage. “Hundreds of workers in Milwaukee shut down a local McDonald’s during the lunch rush, blocking doors, and occupying the drive-thru. Eventually, the employees shut down the entire intersection. ‘After 20 years of hard work, I make $9.65 an hour,’ Jennifer Berry, an employee at McDonald’s told the Milwaukee Biz Times. ‘I am barely able to afford my rent, much less transportation to get to and from work, and groceries. Every month is a struggle just to get by.’”

Yves Smith blogs on the connections between inequality and mental illness: “Greater disparities in wealth and income are associated with increased status anxiety and stress at all levels of the socioeconomic ladder. In the United States, poverty has a negative impact on children’s development and can contribute to social, emotional, and cognitive impairment. A society designed to meet everyone’s needs could help prevent many of these problems before they start…. In The Spirit Level, epidemiologists Kate Pickett and Richard G. Wilkinson show a close correlation between income inequality and rates of mental illness in 12 Organisation for Economic Co-operation and Development member countries. The more unequal the country, the higher the prevalence of mental illness. Of the 12 countries measured on the book’s mental illness scatter chart, the United States sits alone in the top right corner—the most unequal and the most mentally ill… The seminal Adverse Childhood Experiences Study revealed that repeated childhood trauma results in both physical and mental negative health outcomes in adulthood. Economic hardship is the most common form of childhood trauma in the U.S.—one of the richest countries in the world. And the likelihood of experiencing other forms of childhood trauma—such as living through divorce, death of a parent or guardian, a parent or guardian in prison, various forms of violence, and living with anyone abusing alcohol or drugs—also increases with poverty. Clearly, many of those suffering mental and emotional distress are actually having a rational response to a sick society and an unjust economy. This revelation doesn’t reduce the suffering, but it completely changes the paradigm of mental health and how we choose to move forward to optimize human well-being. Instead of focusing only on piecemeal solutions for various forms of social ills, we must consider that the real and lasting solution is a new economy designed for all people, not only for the ruling corporate elite. This new economy must be based on principles and strategies that contribute to human well-being, such as family-friendly policies, meaningful and democratic work, and community wealth-building activities to minimize the widening income gap and reduce poverty.”

Quartz reports on the decision of an Army veteran, Jason Kander, who was running as the Democratic candidate for mayor of Kansas City, to drop out of the race and address his struggles with mental illness: “Last Tuesday, I found out that we were going to raise more money than any Kansas City mayoral campaign ever has in a single quarter,” Kander wrote in a blog post. “But instead of celebrating that accomplishment, I found myself on the phone with the [Veterans Affairs’] Veterans Crisis Line, tearfully conceding that, yes, I have had suicidal thoughts. And it wasn’t the first time.” … Kander himself denied his own symptoms for more than a decade. “When I wrote in my book that I was lucky to not have PTSD, I was just trying to convince myself,” he wrote in his online statement. Kander, however, is now reframing the conversation about mental health: by publicly declaring his decision to “stop running, turn around, and confront” his PTSD and depression, Kander shows that masculinity is not devoid of vulnerability. Gun-toting, successful army veterans get depression too, and they seek help for it… As a man in the public eye, Kander’s openness has the power to shift expectations further, to encourage more men to address mental health concerns.”