Urban Epidemics – second in an occasional series
about chronic diseases and their impact on urban communities.
By Deborah L. Shelton | Tribune reporter
April 28, 2008
De'Jour Stewart remembers feeling happy as he walked to school for a
soccer practice last May. Then, two blocks from his Cabrini-Green home,
shots rang out. As he dived for cover behind a garbage bin, De'Jour
heard bullets ricocheting around him. Nearby, a wounded man slumped in
a car. De'Jour escaped physical harm that day, but he hasn't been the
same boy since.
"Before this happened, I was happy," said a despondent De'Jour, now 11.
"I liked to go places—downtown and around Cabrini—I'd ride my bike all
over." Now he prefers to stay close to home.
"I don't think the world is safe for me," he said.
Twenty-one Chicago public school students have been fatally shot this
school year, victims of violence gripping the city, and others survived
their injuries. But countless more children carry invisible wounds from
witnessing acts of violence up close or even just hearing about it.
People are quick to speak of "an epidemic of violence," but some health
experts say the expression deserves closer attention. Chicago's
violence, they argue, is a public health crisis for its children.
According to a large and growing body of research, exposure to violence
is linked to childhood depression, anxiety, post-traumatic stress
disorder, learning problems, sleep difficulties, poor academic
performance and a host of other problems. Persistent fear, scientists
say, can cause neurophysiological changes in a child's brain that can
impair physiological, behavioral, cognitive and social functioning.
"What we're seeing more and more is that the impact of street violence
and trauma is not just from being a victim, but from living in a
neighborhood where people are talking about it and feeling anxious,"
said Colleen Cicchetti, a pediatric psychologist who directs trauma
services at Children's Memorial Hospital.
Some health professionals believe the impact goes even deeper—that the
fear keeping children like De'Jour off their bikes and behind closed
doors is contributing to increases in obesity, diabetes and other
chronic health problems.
As the ripple effects of violence are increasingly recognized,
collaborations between state, city and private organizations are
forming to help children and families. The Chicago Department of Public
Health operates the Chicago Safe Start program with more than $3
million in funding from the U.S. Department of Justice, and thousands
of early child-care and education providers have completed training on
the effects of childhood exposure to violence.
"From the health department's perspective, when bad things happen to
children and it isn't addressed in a proactive way, it can have
long-term emotional and physical impacts," said Anne Parry, director of
the city health department's office of violence prevention.
"Shame on us if we know this and don't do
something."
'Living in a war zone'
In some Chicago neighborhoods, the city estimates, 25 percent of
children have witnessed a shooting and 30 percent have witnessed a
stabbing.
"We believe this nonsense that kids get adjusted to the gunshots, but
living in a war zone is a form of terrorism," said Carl S. Taylor, a
sociology professor at Michigan State University who has spent more
than 20 years studying violence and children in urban communities.
"I see kids who look old beyond their years. They do not have the joy
and sense of childhood. It's a living hell in these communities, and in
the long run you're not going to produce healthy people."
In the Brighton Park neighborhood, 14-year-old Michelle Formella lost
her next-door neighbor and surrogate big brother to a shooting in
February 2006. Matthew Ramirez was only 16 when he died.
She tries to focus on positive memories, but the shooting "will always
be in my head," she said. "It can really hurt a kid and make them think
differently about the world."
Even children far from a crime scene can be deeply affected.
Demear Thorne, 10, lives in the Logan Square
neighborhood, miles from the Far South Side shooting that took the life
of 16-year-old Julian High School student Blair Holt on a CTA bus last
May.
Holt was killed when an alleged gang member fired at another teenager
seated at the back of the bus. He died shielding a classmate.
Hearing about the incident left Demear terrified of riding a CTA bus.
When he boarded one for the first time since the shooting—nine months
later—the slight boy with wire-rimmed glasses said his heart was
pounding with fear.
"I was hoping I would be safe," he said, tugging at his shirt as if his
heart was leaping out of his chest. "My heart kept going 'thump-thump,
thump-thump.' "
"I was shocked," said Sari Mills, his great-aunt, who learned about his
fear only after quizzing him about his missing book bag. He was so
nervous he had left it at his grandmother's. "We had no idea that he
was going through all this trauma."
Dr. Karen Sheehan, an attending physician at Children's Memorial
Hospital, said some of her pediatric patients confide that they
sometimes have difficulty falling asleep because they feel afraid. She
worries about the emotional and physical toll.
"Lack of sleep leads to obesity, attention-deficit disorders and other
things that feed into a cycle of poor health," said Sheehan, who works
in the hospital's emergency room and in one of its primary-care clinics.
Lower IQ, reading scores
The psychological damage that violence can wreak has
been documented in numerous studies in the last decade.
For example, a study in the Archives of Pediatrics and Adolescent
Medicine in 2002 found that Detroit 1st graders exposed to violence and
trauma-related distress had a lower IQ and reading scores. Researchers
at the University of Illinois at Chicago reported in 1998 that exposure
to community violence resulted in increased aggressive behavior and
depression in African-American and Hispanic boys living in low-income
Chicago neighborhoods. In 1995, researchers found a high percentage of
post-traumatic stress disorder symptoms in teenage girls exposed to
violence in New Haven, Conn.
Among the other consequences is decreased physical activity by children
whose parents restrict time spent outdoors. That can lead to weight
gain, increasing children's risk of developing diabetes, high blood
pressure and other chronic illnesses.
Maryann Mason, associate director of the Child Health Data Lab at
Children's Memorial Research Center, is conducting research on the
physical activity levels of children ages 5 to 10 who live in five
primarily low-income black and Hispanic neighborhoods in Chicago.
Her team has found that the parents most likely to keep their children
indoors weren't always the ones living in areas with the most crime;
they were the ones who thought the crime rate was highest.
"The higher the parental perception of crime, the more sedentary the
kids are after school," Mason said. "It's probably true that they are
keeping them inside to play video games and watch TV."
Beyond its effects on weight, play is the primary means by which
children learn to regulate their emotions and behavior, said Dr. Stuart
Brown, a psychiatrist and president of the National Institute for Play.
"Social learning is fostered by play and exploration," he said. "When
those types of activities are constricted, a child's future is also
constricted."
Experts said the message children get about the city's relentless
violence is equally damaging. The violence reinforces feelings of
limitation, helplessness and loss.
"No matter what they're doing or where they're going, it's in the backs
of their minds—sometimes even in the forefront of their minds—that they
may not be safe," said Brad Stolbach, a psychologist at the Child
Trauma Center at La Rabida Children's Hospital. "Even if children are
not dealing with specific personal loss or injury, they have a
lingering and foreboding sense that the world is not safe."
De'Jour Stewart's mother, Norine Rhodes, said she
has enrolled him in tutoring, mentoring and other programs to give him
an outlet for his energy in a safe, indoor environment.
The shooting shook her to the core. "But you have to keep your child
encouraged, strong and uplifted," she said.
De'Jour said he tries to cope with his fears by avoiding crowds and
staying close to home. He fondly recalls his more carefree life.
"I was happy," he said.
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Copyright © 2008, Chicago Tribune
Related links
* Kids at Cabrini-Green talk about violence Video
* Kidney failure takes deadly toll on blacks in Chicago
* Hundreds gather for peace rally Video
* More stories: Student deaths mount
* Teen shooting victims Teen shooting victims Photos
* CPS students killed throughout the city in the 2007-2008
school year
[24 students, locations mapped so far & related news
story links]
Map data ©2008 Tele Atlas - Terms of Use
View Detailed Version
* Deadly Lessons Video
-- Alice Furumoto-Dawson, Ph.D. Sr. Research Associate Center for Interdisciplinary Health Disparities Research Institute for Mind & Biology University of Chicago Chicago, IL - USA Email: [log in to unmask] http://cihdr.uchicago.edu/