Why Inner City Youth Suffer PTSD

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“The Centers for Disease control says these kids often live in virtual war zones, and doctors at Harvard say they actually suffer from a more complex form of PTSD. Some call it ‘Hood Disease.’” San Francisco KPIX television news anchor Wendy Tokuda spoke these words during a broadcast on May 16, 2014. Behind the anchor desk, a visual graphic featured the words “Hood Disease” in capital letters, in front of a backdrop of a heavily graffitied, boarded up storefront, accented with a strip of yellow police tape.

Yet, there is no such thing as hood disease, and Harvard doctors have never uttered these words. After other reporters and bloggers challenged her about the term, Tokuda admitted that a local resident of Oakland had used the term, but that it had not come from public health officials or medical researchers. However, its mythical nature didn’t stop other reporters and bloggers across the U.S. from reprinting Tokuda’s story and missing the real story: racism and economic inequality take a serious toll on the physical and mental health of those who experience them.

The Connection Between Race and Health

Eclipsed by this journalistic misdirection is the fact that post-traumatic stress disorder (PTSD) among inner city youth is a real public health problem that demands attention. Speaking to the broader implications of systemic racism, sociologist Joe R. Feagin emphasizes that many of the costs of racism born by people of color in the U.S. are health-related, including lack of access to adequate health care, higher rates of morbidity from heart attacks and cancer, higher rates of diabetes, and shorter life spans. These disproportionate rates manifest largely due to structural inequalities in society that play out across racial lines.

Doctors who specialize in public health refer to race as a "social determinant" of health. Dr. Ruth Shim and her colleagues explained, in an article published in the January 2014 edition of Psychiatric Annals,

Social determinants are the main drivers of health disparities, which are defined by the World Health Organization as ‘differences in health which are not only unnecessary and avoidable, but, in addition, are considered unfair and unjust.’ In addition, racial, ethnic, socioeconomic, and geographic disparities in health care are responsible for poor health outcomes across a number of illnesses, including cardiovascular disease, diabetes, and asthma. In terms of mental and substance use disorders, disparities in prevalence persist across a wide range of conditions, as do disparities in access to care, quality of care, and overall burden of disease.

Bringing a sociological lens to this issue, Dr. Shim and her colleagues add, “It is important to note that the social determinants of mental health are shaped by the distribution of money, power, and resources, both worldwide and in the U.S.” In short, hierarchies of power and privilege create hierarchies of health.

PTSD Is a Public Health Crisis Among Inner City Youth

In recent decades medical researchers and public health officials have focused on the psychological implications of living in racially ghettoized, economically blighted inner-city communities. Dr. Marc W. Manseau, a psychiatrist at NYU Medical Center and Bellevue Hospital, who also holds a Masters degree in Public Health, explained to About.com how public health researchers frame the connection between inner city life and mental health. He said,

There is a large and recently growing literature on the myriad physical and mental health effects of economic inequality, poverty, and neighborhood deprivation.  Poverty, and concentrated urban poverty in particular, are especially toxic to growth and development in childhood. Rates of most mental illnesses, including but certainly not limited to post-traumatic stress disorder, are higher for those who grow up impoverished. In addition, economic deprivation lowers academic achievement and increases behavioral problems, thus sapping the potential of generations of people. For these reasons, rising inequality and endemic poverty can and indeed must be viewed as public health crises.

It is this very real relationship between poverty and mental health that San Francisco news anchor, Wendy Tokuda, fixed on when she misstepped and propagated the myth of “hood disease.” Tokuda referred to research shared by Dr. Howard Spivak, Director of the Division of Violence Prevention at the CDC, at a Congressional Briefing in April 2012. Dr. Spivack found that children who live in inner cities experience higher rates of PTSD than do combat veterans, due in large part to the fact that the majority of kids living in inner-city neighborhoods are routinely exposed to violence.

For example, in Oakland, California, the Bay Area city that Tokuda’s report focused on, two-thirds of the city’s murders take place in East Oakland, an impoverished area. At Freemont High School, students are frequently seen wearing tribute cards around their necks that celebrate the lives and mourn the deaths of friends who have died. Teachers at the school report that students suffer from depression, stress, and denial of what is going on around them. Like all people who suffer from PTSD, the teachers note that anything can set off a student and incite an act of violence. The traumas inflicted on youth by everyday gun violence was well documented in 2013 by the radio program, This American Life, in their two-part broadcast on Harper High School, located in the Englewood neighborhood of Chicago’s South Side.

Why the Term "Hood Disease" is Racist

What we know from public health research, and from reports like these done in Oakland and Chicago, is that PTSD is a serious public health problem for inner-city youth across the U.S. In terms of geographic racial segregation, this also means that PTSD among youth is overwhelmingly a problem for youth of color. And therein lies the problem with the term “hood disease.”

To refer in this way to widespread physical and mental health problems that stem from social structural conditions and economic relations is to suggest that these problems are endemic to “the hood” itself. As such, the term obscures the very real social and economic forces that lead to these mental health outcomes. It suggests that poverty and crime are pathological problems, seemingly caused by this “disease,” rather than by the conditions in the neighborhood, which are produced by particular social structural and economic relations.

Thinking critically, we can also see the term "hood disease" as an extension of the “culture of poverty” thesis, propagated by many social scientists and activists in the mid-twentieth century—later soundly disproven—which holds that it is the value system of the poor that keeps them in a cycle of poverty. Within this reasoning, because people grow up poor in poor neighborhoods, they are socialized into values unique to poverty, which then when lived out and acted upon, recreate the conditions of poverty. This thesis is deeply flawed because it is devoid of any considerations of social structural forces that create poverty, and shape the conditions of people’s lives.

According to sociologists and race scholars Michael Omi and Howard Winant’s, something is racist if it “creates or reproduces structures of domination based on essentialist categories of race.” “Hood disease,” especially when combined with the visual graphic of boarded up, graffitied buildings blocked by crime scene tape, essentializes—flattens and represents in a simplistic way—the diverse experiences of a neighborhood of people into a disturbing, racially coded sign. It suggests that those who live in “the hood” are very much inferior to those who do not—“diseased,” even. It certainly does not suggest that this problem can be addressed or solved. Instead, it suggests that it is something to be avoided, as are the neighborhoods where it exists. This is colorblind racism at its most insidious.

In reality, there is no such thing as “hood disease," but many inner-city children are suffering the consequences of living in a society that does not meet their nor their communities' basic life needs. The place is not the problem. The people who live there are not the problem. A society organized to produce unequal access to resources and rights based on race and class is the problem.

Dr. Manseau observes, “Societies serious about improving health and mental health have directly taken on this challenge with substantial proven and documented success. Whether the United States values its most vulnerable citizens enough to make similar efforts remains to be seen.”

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Cole, Nicki Lisa, Ph.D. "Why Inner City Youth Suffer PTSD." ThoughtCo, Aug. 28, 2020, thoughtco.com/hood-disease-is-a-racist-myth-3026666. Cole, Nicki Lisa, Ph.D. (2020, August 28). Why Inner City Youth Suffer PTSD. Retrieved from https://www.thoughtco.com/hood-disease-is-a-racist-myth-3026666 Cole, Nicki Lisa, Ph.D. "Why Inner City Youth Suffer PTSD." ThoughtCo. https://www.thoughtco.com/hood-disease-is-a-racist-myth-3026666 (accessed May 8, 2021).