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."
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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.
The Flynn effect shows people have gotten smarter, but some research claims those IQ gains are regressing. Can both be right?
- Many countries made incredible gains in IQ scores during the 20th century, averaging three IQ points per decade.
- Studies out of Europe have shown a reversal of this trend.
- Such declines are not universal, and researchers remain unsure of what is causing them.
They'll reportedly last for thousands of years. This technology may someday power spacecraft, satellites, high-flying drones, and pacemakers.
Nuclear energy is carbon free, which makes it an attractive and practical alternative to fossil fuels, as it doesn't contribute to global warming. We also have the infrastructure for it already in place. It's nuclear waste that makes fission bad for the environment. And it lasts for so long, some isotopes for thousands of years. Nuclear fuel is comprised of ceramic pellets of uranium-235 placed within metal rods. After fission takes place, two radioactive isotopes are left over: cesium-137 and strontium-90.
New research shows that a healthy supply of locally-sourced beer helped maintain Wari civilization for 500 years.
- A new analysis of an ancient Wari brewery suggests chicha helped maintain the civilization's social capital for hundreds of years.
- Civilizations throughout the ancient world used alcoholic drinks to signify kinship, hospitality, and social cohesion.
- The researchers hope their findings will remind us of the importance in reaffirming social institutions and sharing cultural practices — even if over coffee or tea.
Beer is history's happiest accident. Though the discovery probably happened much earlier, our earliest evidence for beer dates back roughly 13,000 years ago. Around this time, the people of the Fertile Crescent had begun to gather grains as a food source and learned that if they moistened them, they could release their sweetness to create a gruel much tastier than the grains themselves.
One day a curious — or perhaps tightfisted — hunter-gatherer hid his gruel away for a safekeeping. When he returned, he found the bowl giving off a tangy odor. Not one to waste a meal, he ate it anyway and enjoyed an unexpected, though not unpleasant, sensation of ease. By pure happenstance, this ancestor stumbled upon brewing.
That's one possible origin story, but we know that our ancestors learned to control the process, and beer took a central role in Fertile Crescent civilizations — so central that Professor Patrick McGovern, a biomolecular archaeologist at the University of Pennsylvania, argues that beer, not bread, incentivized hunter-gatherers to relinquish their nomadic ways.
Beer may also be proof of a God who wants us to be happy (Dionysus?), because the beverage* would be independently rediscovered by peoples across the ancient world, including those in China and South America.
One such peoples, the pre-Inca Wari Civilization, made beer, specifically chicha de molle, a critical component in their religious and cultural ceremonies. In fact, a study published in Sustainability in April argues that the role was so important that beer helped keep Wari civilization intact for 500 years.
Brewing social capital
Twenty years ago, a team of archaeologists with the Field Museum of Natural History, Chicago, discovered a brewery in Cerro Baúl, a mesa in southern Peru that served as an ancient Wari outpost. The brewery contained original equipment, clay storage vessels, and compartments for milling, boiling, and fermentation.
The team recently analyzed these on-site vessels to uncover the secrets of the Wari brewing process. Removing tiny amounts of material found in the spaces between the clay, they were able to reconstruct the molecules of the thousand-year-old drink. They then worked alongside Peruvian brewers to recreate the original brewing process.**
Their molecular analysis revealed several key features of the beer: The clay used to make the vessels came from a nearby site; many of the beer's ingredients, such as molle berries, are drought resistant; and though alcoholic, the beer only kept for about a week.
These details suggest that Cerro Baúl maintained a steady supply of chicha, limited by neither trade nor fair weather, and became a central hub for anyone wishing to partake. The Wari would likely make such trips during times of festivals and religious ceremonies. Social elites would consume chicha in vessels shaped like Wari gods and leaders as part of rituals attesting to social norms and a shared cultural mythology and heritage.
"People would have come into this site, in these festive moments, in order to recreate and reaffirm their affiliation with these Wari lords and maybe bring tribute and pledge loyalty to the Wari state," Ryan Williams, lead author and head of anthropology at the Field Museum, said in a release. "We think these institutions of brewing and then serving the beer really formed a unity among these populations. It kept people together."
The Wari civilization was spread over a vast area of rain forests and highlands. In a time when news traveled at the speed of a llama, such distinct and distant geography could easily have fractured the Wari civilization into competing locales.
Instead, the researchers argue, these festive gatherings (aided by the promise of beer) strengthened social capital enough to maintain a healthy national unity. This helped the Wari civilization last from 600 to 1100 CE, an impressive run for a historic civilization.
Bringing people together (since 10,000 BCE)
A Mesopotamian cylinder seal shows people drinking beer through long reed straws. Image source: Metropolitan Museum of Art.
Of course, the Wari weren't the first civilization to use beer to reaffirm bonds and maintain their social fabric. Returning to the Fertile Crescent, Sumerians regarded beer as a hallmark of their civilization.
The Sumerian Epic of Gilgamesh tells of the adventures of the titular hero and his friend Enkidu. Enkidu beings as a savage living in the wilderness, but a young woman introduces him to the ways of civilization. That orientation begins with food and beer:
"They placed food in front of him,
They placed beer in front of him,
Enkidu knew nothing about eating bread for food,
And of drinking beer he had not been taught.
The young woman spoke Enkidu, saying:
"Eat the food, Enkidu, it is the way one lives.
Drink the beer, as is the custom of the land."
Enkidu ate the food until he was sated,
He drank the beer — seven jugs! — and became expansive
and sang with joy.
He was elated and his face glowed.
He splashed his shaggy body with water
and rubbed himself with oil, and turned into a human."
Tom Standage, who recounts this scene in his History of the World in 6 Glasses, writes: "The Mesopotamians regarded the consumption of bread and beer as one of the things that distinguished them from savages and made them fully human." Such civilized staples not only demarcated their orderly life from that of hunter-gatherers, they also served a key role in their culture's unifying mythology.
Furthermore, Standage notes, Sumerian iconography often shows two people sipping from waist-high jars through reed straws. The earliest beers were consumed in a similar fashion because technological limitations prevented baking individual cups or filtering the beverage. But the Sumerians had the pottery skills to make such cups and filter the dregs. That they kept the tradition suggests that they valued the camaraderie brought by the experience, a sign of communal hospitality and kinship.
The ancient Greek's similarly used alcohol as a means of maintaining social and political relationships — though their drink of choice was wine.
During symposiums, upper-class Greek men would gather for a night of drinking, entertainment, and social bonding. In Alcohol: A history, Rod Phillips notes that symposiums were serious affairs where art, politics, and philosophy were discussed throughout the night and could serve as rites of passage for young men. (Though, music, drinking games, and sex with prostitutes may also be found on the itinerary.)
Of course, we can amass social capital without resorting to alcohol, which has been known to damage social relationships as much as improve them.
In the 17th century, London's coffeehouses stimulated the minds of thinkers with their caffeine-laden drinks, but also served as social hubs. Unlike the examples we've explored already, these coffeehouses brought together people of different backgrounds and expertise, unifying them in their pursuit of ideas and truths. Thus, coffeehouses can be seen as the nurseries of the Enlightenment.
Relearning ancient lessons
The Field Museum archaeologists hope their research can help remind us the importance social institutions and cultural practices have in creating our common bonds, whether such institutions are BYOB or not.
"This research is important because it helps us understand how institutions create the binds that tie together people from very diverse constituencies and very different backgrounds," Williams said. "Without them, large political entities begin to fragment and break up into much smaller things. Brexit is an example of this fragmentation in the European Union today. We need to understand the social constructs that underpin these unifying features if we want to be able to maintain political unity in society."
So, grab a beer or coffee or tea, spend some time together, and raise a glass. Just try not focus too much on whether your friend ordered Budweiser's swill or an overpriced, virtue-signaling microbrew IPA.
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