'Prevention science' can improve Baltimore's future

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Op-ed by Diana H. Fishbein, The Baltimore Sun, June 11, 2015

Similar to Hurricane Katrina, when the nation's attention turned to the abject poverty in the South, the unrest following the death of Freddie Gray has unveiled the deep-seated and longstanding neglect in Baltimore. Over the past century, Baltimore has become a tinderbox, easily ignited and difficult to extinguish. The young people who looted and set fires after Gray's death were portrayed in the media as hooligans taking advantage of a chaotic situation to misbehave. But closer to the truth, the uprisings are the culmination of decades of public indifference and misguided policies.
 
Freddie Gray died needlessly, but there is a vital takeaway message — a call to action to effectively address the social ills that underlie the unrest. It is imperative that we all take ownership and have the courage to make bold, anticipatory decisions to implement new policies that reverse the damage from our neglect.
 
The task is not easy. Many Baltimore residents face formidable obstacles to breaking intergenerational cycles of poverty, academic failure, violence and drug addiction. It is difficult enough for impoverished residents to meet even the most basic needs of these children; schools try to compensate, but there is little time left for a solid education. Children raised in poverty are also exposed at alarming rates to traumatic experiences that are harmful to brain development and, in turn, diminish academic and social skills crucial for success throughout life.
 
It is unsettling that the Data Resource Center for Child & Adolescent Health reported that nearly 1 in 3 children growing up in Baltimore City experience multiple adverse childhood experiences (ACEs), and at significantly higher rates compared to state and national levels. The Centers for Disease Control and Prevention documented that exposure to ACEs is associated with chronic disease, drinking and drug use, mental health problems and premature death. ACEs tend to accumulate over time, creating a snowball effect of trauma, loss and hardship. Our call to action is to intervene early to alleviate the damage.

Prevention science — one of the most well-established bodies of research on how to improve lives — can provide that guidance. The Institute of Medicine report on prevention concluded that we know enough "to begin to create a society in which young people arrive at adulthood with the skills, interests, assets and health habits needed to live healthy, happy and productive lives in caring relationships with others." As a civilized society we have no excuse to allow adverse conditions to prevail in poor communities in light of evidence that many if not most are preventable.

Diana H. Fishbein is a professor at the University of Maryland School of Medicine, director of the Center for Translational Research on Adversity, Neurodevelopment, and Substance abuse and director of the National Prevention Science Coalition to Improve Lives.

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