Saturday, April 20, 2013

Reducing Violence/Reducing Chronic Disease: The Solution is the Same

This past week has been filled with violence. The media is awash in the bombings at the Boston Marathon, poisoned letters sent to the President and a US Senator and the shooting and chase of the bombing suspects. As if that weren’t enough, incredible anger was voiced about the Senate not voting for stronger gun control measures.

While the media is having a field day over all the various choices for meaty stories, and Facebookers are posting over time their pro or con views on gun control, I find myself once again wondering why we’re not addressing the root issue of violence and what motivates people to use a weapon, be it a penis, knife, poison, black powder, car or gun.

Working with chronic conditions, as well as having spent years working in AIDS, the link between violence and chronic illness has been evident to me for a very long time. Many of the HIV+ women I worked with had incredible violence in their backgrounds, often at very young ages. It wasn’t uncommon to be holding a safer sex workshop and every participant had experienced rape, including some that were left for dead. Domestic violence was so much a part of some women’s lives, that it was standard to hear things like, “Well he wasn’t that bad. He only hit me with an open hand.”

The research now supports what I’ve known for some time, A growing body of science is consistently linking violence (the experience with and/or fear of) with risk for and incidence of a range of serious physical health problems. The effects of violence on health are a consequence of the physical, biological, environmental, social, behavioral, and emotional changes that violence imposes on all of us. While it has been long understood that violence has implications for emotional and physical injury, it is only relatively recently that we are beginning to recognize the longer-term effects that reap an extensive toll on the broader health status of individuals, families and communities. These health consequences include asthma, significant alteration of healthy eating and activity, heart disease and hypertension, ulcers and gastrointestinal disorders, diabetes, neurological and musculoskeletal diseases, and lung disease. … Adults reporting exposure to violence as children had increased likelihood of a number of chronic health conditions compared those without such exposures, especially if their experience involved multiple forms of violence exposures (ischemic heart disease 2.2x, cancer 1.9x, stroke 2.4x, chronic obstructive lung disease 3.9x, diabetes 1.6x, hepatitis 2.4x)

The two questions we need to be addressing, if we truly want to reduce violence (in all forms) and its consequences, are:
-       How do we create an environment and community where people are able to live a life of well-being, contentment and purpose?
-       How do we create a mental health system that helps to identify and effectively treat those in need?

It is important to note that in spite of all we do, there will still be incidences of violence, but significantly less, and because we are mortal, illness and accidents will still be part of our lives.

Tackling this problem is not easy. There is no pill, legislation or “one size fits all” quick fix approach. It is going to require work, cooperation and a belief that change is possible. It will need to come from the grass roots level and include as many different groups as possible, since we are a very diverse country. It needs to come the bottom up, which is the way most effective and sustained change occurs. It also means that we each must become “the change we want to see.”   It’s not okay to think you’ve done your part by sending e-mails to your congressman and reposting comments on Facebook. It means being an active, engaged and fully present part of your family and community.

With that in mind, consider the following:

• The Blue zones project,  which I’ve written about before in this blog, has studied five communities around the world where longevity is common among the majority of the population. They identified nine common denominators. When one looks at these Power Nine it is easy to see why these communities promote a sense of well-being and have less violence and chronic disease than their American counterparts. The Power Nine include:
- Move Naturally
- Know your sense of purpose
- De stress daily
- Eat a plant slant diet
- Don’t over eat
- Drink alcohol moderately
- Belong to a faith based or community group
- Put family (how you choose to define it) first
-       Associate with people who support healthy behaviors

So if you are thinking, “that’s fine if you live on an island, but it wouldn’t work in a city or my community,” think again. There is now a Blue Zones Project initiative to help cities and towns  become Blue Zones Communities. It provides an opportunity for citizens, schools, employers, restaurants, grocery stores and community leaders to work together on policies and programs that will make the most impact and move the community towards optimal health and well-being. Check out the following sites to see the impact it’s had on three communities:
-       Albert Lea, MN 
-       Ten communities in Iowa 

Prevention Institute has developed a series of tools communities, advocates, policymakers etc can use to reduce violence. 

• While improving communities will help to reduce some aspects of mental illness, there will still be a need for effective treatments.  While funding is key-a number of states have cut mental health funding, attitudes are a major barrier to people seeking care. NAMI (National Alliance on Mental Illness) is launching a new campaign to help shed light on mental illness and encourage understanding and conversation. Partnering with Lifetime, the film “Call Me Crazy: A Five Film” airs tonight, April 20 at 8 pm EST. Featured stars include: Jennifer Hudson, Melissa Leo, Octavia Spencer, Sarah Hyland, Sofia Vassilieva, Brittany Snow, Ernie Hudson, Jason Ritter, Jean Smart, Lea Thompson, Melanie Griffith, Chelsea Handler. To learn more about this film and watch the trailer, go to the NAMI website.

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