Urban African Americans are 'startlingly' more likely to live in trauma deserts, researchers say
Access to trauma care is a race issue. It shouldn't be.
- Chicago's South Side didn't have a trauma care unit until last year; the last closed in 1991.
- Whether immediate trauma care or long-term mental health care, access to facilities is limited in minority neighborhoods.
- Since the University of Chicago's Level 1 Trauma Center opened, there's been a seven-fold reduction in the disparity in the city's access to care.
Imagination is one of our most fertile sources of creativity and positive emotional health. The ability to imagine many possibilities during a Rorschach test is indicative of a functional mind open to the possibilities. Unfortunately, trauma stamps out those possibilities. Some veterans, due to traumatic physical or emotional experiences, are unable to portend future scenarios; instead, they replay their personal reel of history over and over.
This phenomenon is not exclusive to war. As a massage therapist friend used to say, "Your issues are in your tissues." Again, this covers the gamut of physical and emotional malaise. Access to health care — immediate in the case of emergency trauma; long-term for chronic mental health conditions — should be universally provided in wealthy nations such as America. But it is not.
We live out trauma in crippling ways. Victims of sexual and physical abuse often find it difficult to imagine a future brighter than their past. Everyone carries the sordid influence of history; if our background involves traumatic incidents, the likelihood we'll become "stuck" greatly increases the possibility that we'll never overcome those instances. They become defining moments in our psychological outlook.
Long-term trauma can result from accidents or intentional attacks: gunshot wounds, heart attacks, muggings, spousal abuse, child abuse. You need not be the victim for repeated incidents to affect your mindset. Living in an environment where repeated instances create chronic trauma affects how your view your future, which is why trauma can be geographical as well.
Last week, I wrote about food deserts, neighborhoods at least one mile from retail grocery stores that offer fresh fruits and vegetables in cities and 10 miles away in rural areas. Limited access to healthy food feeds into obesity rates (among other health problems); it also inspires psychological malaise, as nutrition is influential in outlook.
The Fight For Trauma Care on Chicago's South Side
Food deserts predominantly affect minority populations. Correlation seems implausible. In a media age where "reverse racism" is treated by some outlets as a serious cause of concern, data are sobering reminders that we've not progressed that far in creating an equal playing field. Trauma is another indicator, in accident and attacks as much as systemic mental health challenges.
Let's consider immediate trauma care. A new study from the University of Chicago Medicine, published last week in Journal of the American Medical Association's Network Open, asked one pressing question: Is there an association between race/ethnicity and access to trauma care in U.S. cities? Their answer is yes.
This research was inspired by the university's new Level 1 Trauma Center, which has led to a seven-fold reduction in the disparity in the city's access to care, which the team calls trauma deserts — urban communities at least five miles away from an emergency services.
Located in Hyde Park, the last trauma center in Chicago's south side was closed in 1991. The new center is part of the university's $270 million overhaul. The 18 surgeons and specialists employed at the center were hired to address chronic violence and other health issues in the neighborhood.
Access to such care, according to the study's first author, Elizabeth Tung, is racial in nature:
"So much of the advocacy for the trauma center was framed in terms of racial equity. But we realized no previous studies had addressed trauma access through the lens of race/ethnicity — not just looking at Chicago, but comparing our city to other communities as well."
Demonstrators march in Chicago amid mental healthcare concerns. Photo credit: Scott Olson / Getty Images
The team investigated trauma deserts in Chicago, New York, and Los Angeles. They focused on African-American census tracts to pinpoint communities where trauma care is lacking. In Chicago, 73 percent of census tracts featured predominantly black populations; in Los Angeles, that number jumped to 89 percent; in New York, it was only 14 percent. The researchers noted that in Chicago trauma deserts also greatly affected the Latino population, though that was not the case for New York or Los Angeles.
Before the Level 1 Center opened last May, African-Americans in Chicago were 8.5 times more likely to live far away from trauma access than white census tracts. That number has been reduced to 1.6 times (seven-fold decrease) thanks to the new center.
The paper's senior author, Monica Peek, commented,
"Even though we had a sense that this was a racially divided issue, the data confirmed that this was the case in a significant way. It was pretty startling."
African-Americans (along with Latinos and Asians) are less likely to have access to mental health facilities as well. This is not a separate phenomenon from access to emergency services. The American deserts share similar qualities: lack of access to holistic medical treatment and healthy food. Again and again, these deserts exist along racial lines.
As the researchers conclude, more emphasis needs to be placed on institutions and governments that serve these communities:
"The distribution of trauma centers along racially disparate lines may raise concerns about the legacy of structural inequality that places black lives at higher risk in U.S. cities. Trauma care planning should explicitly address racial equity in the financing of life-saving resources."
- Chicago's South Side Finally Has an Adult Trauma Center Again ... ›
- University of Chicago relents after years of protest, reopens trauma ... ›
- South Side to get adult trauma center after years of protest - Chicago ... ›
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
A recent study gives new meaning to the saying "fake it 'til you make it."
- The study involves four experiments that measured individuals' socioeconomic status, overconfidence and actual performance.
- Results consistently showed that high-class people tend to overestimate their abilities.
- However, this overconfidence was misinterpreted as genuine competence in one study, suggesting overestimating your abilities can have social advantages.
Is this proof of a dramatic shift?
- Map details dramatic shift from CNN to Fox News over 10-year period
- Does it show the triumph of "fake news" — or, rather, its defeat?
- A closer look at the map's legend allows for more complex analyses
Dramatic and misleading
Image: Reddit / SICResearch
The situation today: CNN pushed back to the edges of the country.
Over the course of no more than a decade, America has radically switched favorites when it comes to cable news networks. As this sequence of maps showing TMAs (Television Market Areas) suggests, CNN is out, Fox News is in.
The maps are certainly dramatic, but also a bit misleading. They nevertheless provide some insight into the state of journalism and the public's attitudes toward the press in the US.
Let's zoom in:
- It's 2008, on the eve of the Obama Era. CNN (blue) dominates the cable news landscape across America. Fox News (red) is an upstart (°1996) with a few regional bastions in the South.
- By 2010, Fox News has broken out of its southern heartland, colonizing markets in the Midwest and the Northwest — and even northern Maine and southern Alaska.
- Two years later, Fox News has lost those two outliers, but has filled up in the middle: it now boasts two large, contiguous blocks in the southeast and northwest, almost touching.
- In 2014, Fox News seems past its prime. The northwestern block has shrunk, the southeastern one has fragmented.
- Energised by Trump's 2016 presidential campaign, Fox News is back with a vengeance. Not only have Maine and Alaska gone from entirely blue to entirely red, so has most of the rest of the U.S. Fox News has plugged the Nebraska Gap: it's no longer possible to walk from coast to coast across CNN territory.
- By 2018, the fortunes from a decade earlier have almost reversed. Fox News rules the roost. CNN clings on to the Pacific Coast, New Mexico, Minnesota and parts of the Northeast — plus a smattering of metropolitan areas in the South and Midwest.
Image source: Reddit / SICResearch
This sequence of maps, showing America turning from blue to red, elicited strong reactions on the Reddit forum where it was published last week. For some, the takeover by Fox News illustrates the demise of all that's good and fair about news journalism. Among the comments?
- "The end is near."
- "The idiocracy grows."
- "(It's) like a spreading disease."
- "One of the more frightening maps I've seen."
- "LOL that's what happens when you're fake news!"
- "CNN went down the toilet on quality."
- "A Minecraft YouTuber could beat CNN's numbers."
- "CNN has become more like a high-school production of a news show."
Not a few find fault with both channels, even if not always to the same degree:
- "That anybody considers either of those networks good news sources is troubling."
- "Both leave you understanding less rather than more."
- "This is what happens when you spout bullsh-- for two years straight. People find an alternative — even if it's just different bullsh--."
- "CNN is sh-- but it's nowhere close to the outright bullsh-- and baseless propaganda Fox News spews."
"Old people learning to Google"
Image: Google Trends
CNN vs. Fox News search terms (200!-2018)
But what do the maps actually show? Created by SICResearch, they do show a huge evolution, but not of both cable news networks' audience size (i.e. Nielsen ratings). The dramatic shift is one in Google search trends. In other words, it shows how often people type in "CNN" or "Fox News" when surfing the web. And that does not necessarily reflect the relative popularity of both networks. As some commenters suggest:
- "I can't remember the last time that I've searched for a news channel on Google. Is it really that difficult for people to type 'cnn.com'?"
- "More than anything else, these maps show smart phone proliferation (among older people) more than anything else."
- "This is a map of how old people and rural areas have learned to use Google in the last decade."
- "This is basically a map of people who don't understand how the internet works, and it's no surprise that it leans conservative."
A visual image as strong as this map sequence looks designed to elicit a vehement response — and its lack of context offers viewers little new information to challenge their preconceptions. Like the news itself, cartography pretends to be objective, but always has an agenda of its own, even if just by the selection of its topics.
The trick is not to despair of maps (or news) but to get a good sense of the parameters that are in play. And, as is often the case (with both maps and news), what's left out is at least as significant as what's actually shown.
One important point: while Fox News is the sole major purveyor of news and opinion with a conservative/right-wing slant, CNN has more competition in the center/left part of the spectrum, notably from MSNBC.
Another: the average age of cable news viewers — whether they watch CNN or Fox News — is in the mid-60s. As a result of a shift in generational habits, TV viewing is down across the board. Younger people are more comfortable with a "cafeteria" approach to their news menu, selecting alternative and online sources for their information.
It should also be noted, however, that Fox News, according to Harvard's Nieman Lab, dominates Facebook when it comes to engagement among news outlets.
CNN, Fox and MSNBC
Image: Google Trends
CNN vs. Fox (without the 'News'; may include searches for actual foxes). See MSNBC (in yellow) for comparison
For the record, here are the Nielsen ratings for average daily viewer total for the three main cable news networks, for 2018 (compared to 2017):
- Fox News: 1,425,000 (-5%)
- MSNBC: 994,000 (+12%)
- CNN: 706,000 (-9%)
And according to this recent overview, the top 50 of the most popular websites in the U.S. includes cnn.com in 28th place, and foxnews.com in... 27th place.The top 5, in descending order, consists of google.com, youtube.com, facebook.com, amazon.com and yahoo.com — the latter being the highest-placed website in the News and Media category.
If you thought your mother was pushy in her pursuit of grandchildren, wait until you learn about bonobo mothers.
- Mother bonobos have been observed to help their sons find and copulate with mates.
- The mothers accomplish this by leading sons to mates, interfering with other males trying to copulate with females, and helping sons rise in the social hierarchy of the group.
- Why do mother bonobos do this? The "grandmother hypothesis" might hold part of the answer.
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