Category Archives: Violence and Trauma

Nov 19 2014
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Population Sickness and Population Health: How Geographic Determinants Differ

Tamara G.J. Leech, PhD, is an associate professor in the Department of Social and Behavioral Sciences at the Indiana University Richard M. Fairbanks School of Public Health, and a former Robert Wood Johnson Foundation (RWJF) New Connections program grantee. She is principal investigator of a William T. Grant Scholar Award, “Pockets of Peace: Investigating Urban Neighborhoods Resilient to Adolescent Violence.”  

Tamara G. Leech

I am particularly excited about the American Public Health Association’s (APHA) Annual Meeting theme this year—Healthography! My research team has spent the past two years examining “cold spots” of urban youth violence. In other words, we have been analyzing areas where—regardless of the increased risk for violence—violence is not occurring or is rarely occurring. This is a departure from the dominant form of research on “hot spots” of violence, or any disease for that matter.  

American Public Health Association Meeting & Expo

For some, this approach has been puzzling. It’s not immediately obvious that the determinants of cold spots are not simply the opposite of the determinants of hot spots.  However, our evidence clearly suggests that the things that help to make a location healthy go well beyond the things that protect a location from high rates of illness.

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Nov 13 2014
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Addressing the Needs of Female Veterans Who Have Experienced Violence and Harassment

Jacquelyn Campbell, PhD, RN, FAAN, is director of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program and Anna D. Wolf chair and professor at the Johns Hopkins University School of Nursing.  Angela Amar, PhD, RN, FAAN, is an associate professor at the Nell Hodgson Woodruff School of Nursing at Emory University and an alumna of the RWJF Nurse Faculty Scholars program.

Jacquelyn Campbell Jacquelyn Campbell

As two scholars who have worked in research, practice and policy arenas around issues of gender-based violence for years, we honor our veterans this week by paying tribute to the Pentagon and the U.S. Department of Veterans Affairs (VA) for addressing intimate partner and sexual violence among active duty and returning military and their families, and urge continued system-wide involvement and innovative solutions.  

In our work, we’ve heard outrageous, painful stories. One female servicemember explained to Angela why she was ignoring the sexual harassment she experienced. She knew that hearing that she was inferior because she was a woman, being called “Kitty” instead of her name, and having the number 69 used in place of any relevant number was harassing. She knew it was wrong. But she had decided that she would not let it bother her. I can acknowledge that he is a jerk, but I can’t let that affect me.  

Angela Amar Angela Amar

I can’t let his behavior define me as a person. On some level this may seem like an accurate way of dealing with a problem person. However, sexual harassment isn’t just about one obnoxious person. Not telling the story doesn’t make the behavior go away. Rather, it sends the message that the behavior is acceptable and that sexist comments are a normal part of the lexicon of male/female interactions.

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Jul 29 2014
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Childhood Trauma: A Public Health Problem that Requires a Robust Response

Cindy A. Crusto, PhD, is a Robert Wood Johnson Foundation (RWJF) New Connections grantee, an associate professor of psychology in psychiatry, Yale University School of Medicine, and a Public Voices Fellow with The OpEd Project.

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Were the findings really a surprise? The recent release of the report The Burden of Stress in America commissioned by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health, highlights the major role that stress plays in the health and well-being of American adults. As a researcher who studies the impact of emotional or psychological trauma on children’s health, I immediately thought about the findings in the context of trauma and the associated stress in the lives of children. That trauma can include violence in the home, school, and community.

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Two decades of research has produced clear findings on this significant public health problem: Psychological trauma can have a powerful influence in the lives of children, and if not detected and addressed early, it can (and often does) have long-lasting physical and mental health effects into adulthood. Despite this strong evidence, I have encountered the sheer resistance of some advocates who work with or on behalf of vulnerable children to fully engage in this topic. Perhaps it’s because of the belief that this talk about trauma is a fad—a hot topic that will fade as soon as something “sexier” comes along.

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Jul 17 2014
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RWJF Scholars in the News: Gun violence, suicide, ‘structural’ versus ‘cultural’ competency, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

An NPR story quotes RWJF Health & Society Scholars program alumnus Andrew Papachristos, PhD, citing his extensive research on gun violence. Papachristos criticizes the lack of context in media coverage of violence, noting that incidents such as the series of shootings over the Fourth of July weekend in Chicago tend to be treated simply as a long stretch of violent incidents. “Treating Chicagoland violence as merely a tally necessarily dehumanizes its victims, but it also obscures so much of the larger story about that violence. It's data without context.” Not only is the murder rate steadily declining in Chicago, but there is a massive disparity in victims of these crimes: “Eighty-five percent of violence—any shootings—happens among 5 percent of people,” Papachristos says.

In an article about libertarianism and state laws related to guns and other topics, the Economist cites a study about the social costs of gun ownership by RWJF Investigator Award in Health Policy Research recipients Philip Cook, PhD, and Jens Ludwig, PhD. It finds that “more guns empirically lead to more gun-related violence, largely because legally purchased guns somehow end up in the hands of criminals via theft,” gun shows, and online sales, which are largely unregulated. To address these issues, Cook and Ludwig suggest making it costlier to buy guns in high-crime areas, and improving the records used to screen gun buyers by including more information on possible mental-health problems, among other proposals. (Free registration required to view article.)

A study co-authored by RWJF Health & Society Scholars program alumnus Alexander Tsai, PhD, MD, finds that men who are more socially connected are half as likely to commit suicide as men considered loners, NBC News reports. The study looks at data on nearly 35,000 men, ages 40 to 75, and finds that those who are more isolated are at greater risk, even if they are not mentally ill. “Public health practitioners think about things like cardiovascular disease as warranting public health attention,” says Tsai, suggesting that suicide may also need attention.

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Jun 12 2014
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RWJF Scholars in the News: Alzheimer’s disease, violence against women, drug marketing, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Jason Karlawish, MD, participated in the design of new research that offers “an opportunity to study the future of the way we’re going to think about, talk about and live with the risks of Alzheimer’s disease,” he tells the Associated Press. The study is aimed at testing an experimental drug to see if it can protect seniors who are healthy but whose brains “harbor silent signs” of risk, such as a sticky build-up of proteins that can be a precursor to Alzheimer’s. Karlawish is an RWJF Investigator Award in Health Policy Research recipient. Read more about his work on Alzheimer’s disease here and here.

The work of RWJF Scholars in Health Policy Research alumni Ted Gayer, PhD, and Michael Greenstone, PhD, is featured in an Economist article about incorporating into federal cost-benefit analyses the global benefits of regulation to reduce carbon emissions, rather than benefits that accrue only to the United States. Agencies conduct such analyses before promulgating regulations to test whether the estimated benefits of a regulation exceed the estimated costs. Typically, estimated benefits include only those that accrue to the United States, but because global warming reaches far beyond U.S. borders, the Obama Administration’s calculations include global benefits. Greenstone was also recently cited in the New York Times.

Chris Uggen, PhD, an RWJF Investigator Award recipient, writes about the decline in the incidence of sexual violence and intimate partner violence against women since 1993 in a Pacific Standard article. Rates of sexual violence and intimate partner violence decreased from almost 10 per 1,000 in 1994 to 3.2 per 1,000 in 2012, Uggen writes. While those numbers are encouraging, “misogyny and violence against women remain enormous social problems—on our college campuses and in the larger society,” he says. Uggen’s post also appeared on Sociological Images, a Pacific Standard partner site.

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Jun 5 2014
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RWJF Scholars in the News: Diversity in the nursing workforce, barriers to breast-feeding, child maltreatment, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

HealthLeaders Media features New Careers in Nursing (NCIN), a joint initiative of RWJF and the American Association of Colleges of Nursing (AACN) that is increasing diversity in the nursing workforce. “The reason [increasing diversity] is important, of course, is because the population of nursing does not really reflect the population at large,” Polly Bednash, PhD, RN, FAAN, says in the story. “We are now working very aggressively to have the number of people entering the profession look more like the population of the United States.” Bednash is NCIN program director and AACN’s CEO.

In an opinion piece for the Philadelphia Inquirer, Jooyoung Lee, PhD, writes that, in the aftermath of mass shootings, the media and public often focus chiefly on the shooters and forget about the families of those slain. “Instead of fixating on the shooter, or retreating into our own lives, let’s remember and honor those who are left behind. Their lives are often difficult and grinding; their grief is immeasurable. Healing from murder is rarely—if ever—a quick or complete process,” writes Lee, an RWJF Health & Society Scholars program alumnus. Read more about Lee’s work.

Living in neighborhoods with high rates of violence can affect students’ academic performance, according to a study from RWJF Health & Society Scholars program alumnus from Patrick Sharkey, PhD. The Washington Post reports that the study found that neighborhood violence that occurred within seven days of a test appeared to reduce Black children’s performance on language arts assessments. “When violence is in the air, when the threat of violence is in the air, then it becomes something that spills over to affect not just people who are involved, but everyone who lives in the community,” Sharkey says.

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May 8 2014
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RWJF Scholars in the News: How breast cancer treatment affects patients’ lives, nurses improving mental health care, male victims of sexual assault, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Experts are looking at how treatment for breast cancer affects patients’ lives, HealthDay reports. A study by Reshma Jagsi, MD, PhD, an RWJF Physician Faculty Scholars alumna, finds that women who undergo chemotherapy treatment for breast cancer are more likely to end up unemployed than patients whose treatment does not include chemotherapy. Four years after treatment for early stage breast cancer, the study found, more than one-third of those who had chemotherapy were out of work, compared to just over one-quarter of women who had other treatments. “Many of us realize the chemotherapy is going to knock the wind out of your sails temporarily. We [as doctors] have tended to assume women bounced back, and the results here suggest that’s not the case,” Jagsi said. The HealthDay article was republished in U.S. News & World Report, WebMD, and Medicinenet.com, among other outlets.

In the latest edition of the Health Affairs “Conversations” podcast series, Sherry Glied, PhD, recipient of an RWJF Investigator Award in Health Policy Research, discusses lessons learned from the first open enrollment period of the Affordable Care Act. She and other experts also discuss Medicaid expansion, and payment and delivery reforms.

Children of single mothers who unexpectedly lose their jobs suffer severe negative repercussions well into their adult years, according to a study co-authored by Jennie Brand, PhD, MS, an RWJF Health & Society Scholars alumna. They are less likely to graduate from high school and college, and more likely to endure depression, the LA Times reports. Additionally, “[t]he kids, by virtue of having less education and having some social psychological issues, could themselves be at greater risk of job loss in the future,” Brand said. “That’s a concern too, that we could potentially see an inter-generational transmission of job instability.” 

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Apr 24 2014
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RWJF Scholars in the News: Markers for PTSD, inexcusable morbidity, nurse education, cigarette marketing, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Neuroscientists at Harvard University studying trauma and the adolescent brain have identified markers that might help predict susceptibility to post-traumatic stress syndrome (PTSD), New England Public Radio (NEPR) reports. Kate McLaughlin, PhD, an RWJF Health & Society Scholars alumna, and colleagues were studying young people who’d been through serious adversity when the Boston Marathon bombing occurred. They surveyed some study participants who had already had brain scans about how much media coverage of the tragedy they’d watched and how they reacted emotionally, learning that children with certain neurobiological markers or previous trauma were more likely to report symptoms of PTSD. “The more that we can understand the neurobiological markers as well as the psychological and social markers ... the better able we’ll be to deliver early and effective interventions to prevent the onset of mental health problems,” she tells NEPR. Listen here.

“People think about asthma and think we must have a handle on it in the United States, but the grim reality is that most patients’ asthma in this country is uncontrolled,” David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus tells Nonprofit Quarterly in an interview. Van Sickle points to little progress in reducing asthma-related hospitalizations, and what he describes as “inexcusable morbidity” from the condition.  

RWJF Executive Nurse Fellows alumna Jane Kirschling, RN, PhD, FAAN, is featured in Nurse.com on the importance of nurse education. “We’re the largest single group of health care providers in the United States, and we’re there 24-7, 365 days a year for the care that’s provided,” Kirschling said. “That’s in hospitals, community settings and long-term care settings. So, we have to make that commitment as a discipline and as professional nurses to continue to expand our knowledge and our critical thinking skills, and we do that through advancing nursing education.”

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Apr 8 2014
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Preventing Youth Violence May Cost Less Than You Think…

Adam L. Sharp, MD, MS is an emergency physician and recent University of Michigan Robert Wood Johnson Foundation Clinical Scholar (2011-2013). He works for Kaiser Permanente Southern California in the Research and Evaluation Department performing acute care health services and implementation research.

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Violence is a leading cause of death and injury in adolescents. Recent studies show effective interventions can prevent violent behavior in youth seen in the Emergency Department (ED). Adoption of this type of preventive care has not been broadly implemented in EDs, however, and cost concerns frequently create barriers to utilization of these types of best practices. Understanding the costs associated with preventive services will allow for wise stewardship over limited health care resources. In a recent publication in Pediatrics, "Cost Analysis of Youth Violence Prevention," colleagues and I predict that it costs just $17.06 to prevent an incident of youth violence.

The violence prevention intervention is a computer-assisted program using motivational interviewing techniques delivered by a trained social worker. The intervention takes about 30 minutes to perform and was evaluated within an urban ED for youth who screened positive for past year violence and alcohol abuse. The outcomes assessed were violence consequences (i.e., trouble at school because of fighting, family/friends suggested you stop fighting, arguments with family/friends because of fighting, felt cannot control fighting, trouble getting along with family/friends because of your fighting), peer victimization (i.e., hit or punched by someone, had a knife/gun used against them), and severe peer aggression (i.e., hit or punched someone, used a knife/gun against someone).

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Mar 20 2014
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RWJF Scholars in the News: ADHD medication, reconstruction after mastectomy, care for returning veterans, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

NBC News reports on a surge in the number of young adult women taking ADHD medication. An RWJF Investigator Award in Health Policy Research recipient, Stephen Hinshaw, PhD, explains that the rise in diagnoses among women in that age group may be evidence of failure to recognize the problem when the women were children. They may not have manifested symptoms as visibly as their male classmates with ADHD did, turning their distress inward rather than misbehaving in class, for example.

“How people with mental disorders are viewed by treatment providers and the general public can have a significant impact on treatment outcomes and the quality of life of clients,” Jennifer Stuber, PhD, and colleagues write in a study reported by Health Canal. The researchers presented vignettes about people with mental health problems to mental health providers and the general public, and compared their reactions. Providers had more positive attitudes, but some held views about the danger such patients might pose in the workplace that the researchers called “concerning.” Stuber is an RWJF Health & Society Scholars alumna.

More women are having breast reconstruction after mastectomies, USA Today reports. As a result of a 1998 federal law, most group insurance plans that cover mastectomies also cover breast reconstruction. Researchers found that the share of women who received reconstruction after mastectomy rose from 46 percent to 63 percent between 1998 and 2007. Author Reshma Jagsi, MD, DPhil, an RWJF Physician Faculty Scholars alumna, says the law could be contributing to the increase. The study was also covered by 9 News (Denver) and WKYC.com (Cleveland), among other outlets.

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