Baltimore children feel health impact of neighborhood violence

The kids were growing up in Upton/Druid Heights, where backyard police chases are common and sirens wake up kids like unwelcome alarm clocks at night. Almost every day, in some way, the kids were exposed to violence.

…For every child who is shot, provoking public outrage, there are hundreds of others who hear gunshots or see fights and stabbings in neighborhoods across the city. After the ambulances drive off and the crime scenes are cleared, many of these children are left with deep psychological wounds that can trigger physical ailments.

Studies have piled up showing that in the tangle of tough, intractable issues like poverty and drug addiction, exposure to violence is a major factor damaging children’s health. The stress that fills their little bodies breeds anxiety and depression, making it hard for them to concentrate in school. In fact, research has found that such experiences hurt the development of crucial areas of their brains — those involving attention, memory and behavior control. In the worst cases, children walk around with symptoms of post-traumatic stress disorder no different from those plaguing soldiers who have fought on the front lines.

According to one researcher who has long studied these children, nearly a third of children exposed to violence will develop PTSD. As the children age, researchers believe, the impact of violence can translate into serious health problems, including hypertension and diabetes. Some early research shows that stress may even alter their DNA.

…“The science has caught up. You cannot raise a kid with high levels of trauma and violence and expect they can just bounce back,” said Martha Davis, senior program officer at the Robert Wood Johnson Foundation, which has funded projects in high-crime areas to address the problem. “Now the hard work is: How do we take this information and make systems that work?”

…A man her family knew, 23-year-old Brandon Simms, had been eating crabs in the courtyard about 8 p.m., when another man walked up to him, pulled out a gun and shot him in the leg. As the girl and other neighbors watched from yards away, Simms tried to crawl away. The shooter fired again — this time into Simms’ head.

The girl’s mother, awakened from a nap by the firecracker-like sounds, ran outside. She found her daughter in tears, crouching in the doorway and holding tightly to a younger neighbor. A teenage daughter, who was also outside, ran to a nearby playground and hid in a play tunnel. Terrified, she didn’t move until she heard her mother’s voice calling her.

Bullet holes remain in the sidewalk today — and the impact on the family lingered as well.

…Three years ago, when Promise Heights social workers began their work at Furman L. Templeton and the Samuel Coleridge-Taylor, they found classic symptoms of children stressed by violence.

Students were hypervigilant and suffering from anxiety and depression. Small conflicts blew up into huge fights, and many children had a hard time concentrating. Mundane acts triggered bad memories in kids and sparked tantrums — for example, a child would flinch at a teacher’s gesturing with her hands because it looked like hitting.

…health problems related to societal issues.

The stressed children have worsened asthma. Some need stitches from being beaten up on the way to school. Many have Vitamin D deficiencies because they don’t get enough sunlight — there are few playgrounds, and children are either afraid to be outside, or their parents think it’s safer for them to stay indoors.

Some children are so angry and emotionally numb, Fulton noted, that they never feel afraid. And it’s not surprising, experts say, that in school, many of the children can’t focus for more than 10 minutes.

Some efforts to improve educational outcomes for these kids may have overlooked this crucial factor, noted the University of Maryland’s Mayden. For years, public schools have tried many strategies — new curricula, more professional development for teachers, or changing a principal — without seeing a big improvement in achievement, she said.

…The human body is designed to adapt to stressful situations. In dangerous moments, energy levels rise, the heart pumps faster, and the hormones adrenaline and cortisol kick in. Those changes allow people to run faster and defend themselves. When the situation calms down, the body goes back to normal. Scientists call this the “fight or flight” response.

But for kids in Upton/Druid Heights, where crime and violence are common, this system gets overloaded, because things never really calm down. A distant gunshot. A fight in the courtyard. A memorial of flowers and balloons for a homicide victim. Kids who live in these communities stay in a continuous state of alertness, always prepared for something dangerous to happen — even if they don’t realize it.

Elevated levels of stress hormones can reach toxic levels that have a lifetime effect on health, derailing development of the brain and leading to physical problems, according to research from Harvard University, the Stanford University School of Medicine and other institutions.

…Researchers like Carrion believe that — in a child who can’t sit still in school, or is so agitated that he or she throws a chair — the brain is so busy fending off stress that other key areas don’t develop properly. Carrion’s scans of stressed children found a smaller prefrontal cortex, the part of the brain responsible for executive functions such as attention span, planning and organizing, goal-setting and behavior control. Carrion also gave the stressed children attention and memory tests — and the prefrontal cortex was not as active.

Other brain scan studies showed stunted growth of the hippocampus, which may inhibit a child’s ability to form new memories, learn or control emotions. The symptoms were worse for kids who experienced trauma more directly, Carrion said.

“The more interpersonal it is in terms of family or someone close to you, the more it affects you,” Carrion said. “It’s like being close to the epicenter of the earthquake [rather than] miles away.”

…His research team interviewed more than 700 children at Baltimore Polytechnic Institute and Western, Patterson and Walbrook high schools, all in neighborhoods with violence and other social stressors that he found put some kids on constant alert and caused their blood pressure to rise.

The flight-or-fight response that elevated stress hormones also elevated heart rates in these children, said Ewart, who found the same symptoms in students in Syracuse. Being constantly vigilant to possible dangers for long periods can cause wear and tear on the heart and the blood vessels, Ewart said. He compared it to a badly tuned car engine that runs too fast, burns too much gas, overheats, and requires constant braking. Everything wears out early. In adolescents, the wear and tear of constant stress can lead to hypertension and early heart disease when they are older.

…In the Little Flowers day care, for example, teachers are dimming the lights at different times to help calm the kids, or conducting some activities outside, where sunshine and fresh air may help them focus.

…“While there is enormous potential for traumatized children and families to get help to recover through evidence-based treatments and program strategies, the funding to support their proliferation needs to be far greater than it currently is, given the public health crisis we face,” said Dr. Steven Marans, the director of Yale’s center and the Harris Professor of Child Psychiatry.

But many programs in the Promise Heights initiative have ripple effects. As adults are supported in various ways, they can support the kids. And research has shown that having a bond with an adult is a powerful way for children to overcome the consequences of violence, poverty and other social ills. Even an adult who is not a relative can offer stability.

“Attachment is critical for the child to develop self-regulation of their emotions,” said Belcher, of Kennedy Krieger. “So when you get a little frustrated, you’re resilient, you come back.”

…Amanda Malone-Diel, a University of Maryland graduate student in social work who counseled students at Samuel Coleridge-Taylor, remembers following a kindergartner who ran all over the school — to the first floor, second floor, gym, bathroom and cafeteria. Then one day, the social worker stopped chasing her and simply waited in one spot.

Gradually, the girl started to run back to her counselor. And sometimes, she wouldn’t run at all. Instead, they’d sit together, one hand on chest, one hand on tummy, and breathe. There, amid all the neighborhood troubles, Malone-Diel created an oasis of quiet, a chance to take the student to a more peaceful place, if only for a few minutes.

“One, two, three, breathe,” Malone-Diel said slowly. “One, two, three, breathe.

Baltimore children feel health impact of neighborhood violence – Baltimore Sun



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