Morning Zen

Scientific Healing of Historic Disparities: Creating Equity in Educational and Economic Outcomes

August 15, 2021

Many white folks—especially in politics—pretend there is no such thing as historic disparities affecting racial minorities in America, especially in places where I grew up in Kansas, Oklahoma, Texas, and Arizona. In my senior high-school class in 1967, of 312 kids, there was only one Black boy and three Black girls. My father always noticed such discriminatory slights, and he did his best to do seditious things like taking pictures of Black weddings, funerals, portraits, and other such kindnesses. I think he did that because he knew the family secret—we were descendants of Slavery, something I only learned twenty years ago.

In that same twenty years, I’ve been working in Baltimore City Public Schools and other places to reduce lifetime harms of historic disparities of children and their futures. If you listened to the radio or watched regular TV, you would have no idea that scientists like me know how to mend those effects of historic disparities. More importantly, we’ve proven how economical and socially sound it is to do so. I can rattle off a dozen practical and proven studies that can be scaled up, all across America. The results could dramatically cut the cost of the prison industry, pharmaceuticals, and other problematic indicators. And yes, that requires critical thinking, due diligence, and programmatic design—the hallmarks of human greatness.

There’s a serious economic problem, though. The things that work are cheap, seriously inexpensive, and cost-effective. I’m not talking about somebody’s pet idea; I’m talking about strategies with incredible science in Surgeon General Reports and U.S. Institute of Medicine Reports. 

You won’t see any ads on any of the hundreds of cable channels discussing the use of these simple, powerful, scientific strategies proven to reduce historic disparities. However, you will hear about medications for diseases and disorders on those same cable channels. All are costly.

However, what America needs is better social, educational, physical, and financial well-being and social equity. True well-being and equity can power America into the next hundred years. Just do an internet search on “the danger of inequality” to understand why every community in America needs simple, cost-effective, proven strategies to reduce inequality and increase equity for greater peaceproductivityhealth, and happiness. Those four “compass points” of human well-being require constant monitoring and tinkering to achieve results in shifting challenges.

Not everybody wants these outcomes of more peace, productivity, health, and happiness, however. A great deal of money is spent cleaning up violence, poor productivity, and poor health across many public and private companies or institutions. Thus, unhappiness grows like weeds in our families, communities, and workplaces—some prey on that unhappiness with illegal drugs, crime, and false political promises.

Focus your brain and think critically about who will lose lots of money if Black, Brown, Red, Yellow, Mixed, and poor White kids ALL did better at school, in the workplace, in their health, and the community, now and in the future. Imagine all those kids are all healthier in body and brain, too. Imagine fewer Americans are abusing hard drugs like Oxy or other opiates, let alone tobacco and alcohol. Many human enterprises—legal or not—thrive on carrion. It takes spiritual, intellectual, and political will and knowledge to redraw the map for the right course.

Further, imagine that huge numbers of children never experience ACE’s henceforth because of behavioral strategies launched at a population level for $7 per child’s lifetime [1]. Or babies were never exposed to drugs in utero because of a simple, easy-to-implement strategy [2]. Our work on the Good Behavior Game is one such proven strategy, saving about $10,000 per child from the school-to-addictions, psychiatric disorders, welfare, and the prison pipeline [3]. That is just one massively proven prevention strategy in Surgeon General and Institute of Medicine Reports. But how big are the problems of America’s children and youth? It’s enormous, and it takes a big collective vision and effort to get our children’s lives back on track, regardless of race or creed.

Right now, better than half of all American children are taking psychotropic medications in 2010 [4], and the numbers and the percentages of children doing so keeps increasing [5-7]. Clinicians, parents, kids, teachers, and community members compare notes about these meds in various chat and blog posts.  It’s very costly, and only an expensive band-aid that has to be changed every day, sometimes several times a day.

It’s common to see the sheer absence of professional, social, and policy inquiry about the well-proven scientific knowledge for preventing almost every childhood psychiatric disorder. Oh, but you will see ads on cable and broadcast television for a dizzying array of such meds. These medications are now the single most costly budget item in Medicare and private insurances for children. Most people think of prevention science as lectures or other noise making.

It is far more useful to think of incredible prevention science like washing your hands, putting on seatbelts, stopping at traffic lights, or wearing a surgical mask in the operating room or during a pandemic. These are what are called “behavioral vaccines” [8-11]. Multiple “behavioral vaccines” prevent and reduce the national epidemic of mental, emotional, educational, and behavioral disorders.

So, here is a quiz for self-reflection. What are the behavioral vaccines that can prevent or reduce any of these common mental/behavioral health diagnoses:

  1. Bipolar disorder and schizophrenia?
  2. Depression?
  3. ADHD/with or without aggression?
  4. Aggression/homicide?
  5. Child obesity?

Only a handful of nerds might be able to answer correctly. Everybody should know in pediatric medicine, education, social services, and the juvenile justice system. None of the effective prevention strategies involve teaching people about the disorders. None of the prevention strategies require a prescription. None of these preventive strategies are costly. And, all of these prevention strategies have been around for a very long time. Every one of them has been in many past federal and private reports—but never as “advertised on TV.”

Wouldn’t it be cool if those prevention strategies—touted by multiple Surgeon Generals and Institute of Medicine Reports—were promoted on TV with the frequency of psych meds? Lordy, we’d save a heck of a lot of money as well as a lot of pain and suffering! Our streets and lives would be a lot safer and saner. That would be social justice. Now is the time for all of us to act in light of the future.

PS: This is not a money problem. Money is everywhere to solve these problems, but it does involve choosing and using world-class science tested many times and published in the National Library of Medicine, www.pubmed.gov. Reducing these costly problems can transfer all those resources to build a better America and a better world. I’m happy to explain what those studies are and can do. Please send me an email. If not now, when? If not us, then who?

  1. Prinz, R.J., et al., Population-based prevention of child maltreatment: The U.S. triple P system population trial. Prevention Science, 2009. 10(1): p. 1-12.
  2. Petry, N.M., Contingency management for substance abuse treatment: A guide to implementing evidence-based practice. 2012: New York, NY, US: Routledge/Taylor & Francis Group. xiii, 320.
  3. Aos, S., et al. Good Behavior Game, Return on Investment: Evidence-Based Options to Improve Statewide Outcomes. 2019. 8.
  4. Mathews, A.W., So Young and So Many Pills: More than 25% of Kids and Teens in the U.S. Take Prescriptions on a Regular Basis, in Wall Street Journal. 2010, The News Corporation: New York.
  5. Soni, A., Trends in the Five Most Costly Conditions among the U.S. Civilian Noninstitutionalized Population, 2002 and 2012, in Statistical Brief (Medical Expenditure Panel Survey (US)). 2001, Agency for Healthcare Research and Quality (US): Rockville (MD).
  6. Soni, A., The Five Most Costly Children’s Conditions, 2006: Esitmates for the U.S. Civilian Non-institutionalized Children, Ages 0-17., A. Center for Financing, and Cost Trends, Editor. 2009, Agency for HealthCare Research and Quality: Rockville, MD. 20850. p. 5.
  7. Soni, A., The Five Most Costly Children’s Conditions, 2011: Estimates for U.S. Civilian Noninstitutionalized Children, Ages 0-17, A.f.H.R.a. Quality, Editor. 2014, Agency for Healthcare Research and Quality: Washington, DC.
  8. Embry, D.D., Behavioral Vaccines and Evidence-Based Kernels: Nonpharmaceutical Approaches for the Prevention of Mental, Emotional, and Behavioral Disorders. Psychiatric Clinics of North America, 2011. 34(March): p. 1-34.
  9. L’Abate, L., ed. Low-Cost Approaches to Promote Physical and Mental Health: Theory, Research and Practice. 2007, Springer: New York. 526.
  10. Embry, D.D., Community-Based Prevention Using Simple, Low-Cost, Evidence-Based Kernels and Behavior Vaccines. Journal of Community Psychology, 2004. 32(5): p. 575.
  11. Van Voorhees, B.W., et al., Internet-based depression prevention over the life course: a call for behavioral vaccines. Psychiatr Clin North Am, 2011. 34(1): p. 167-83.
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About the Author

Dennis Embry

Dr. Dennis Embry is a prominent prevention scientist in the United States and Canada, trained as a clinician and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson and co-investigator at Johns Hopkins University and the Manitoba Centre for Health Policy. Dr. Embry serves as a National Advisory Council member and Chief Science Advisor to the Children’s Mental Health Network.

Dr. Dennis Embry has been recognized by the Child Welfare League of America as one of the 100 Champions for Children. As part of CWLA’s 100th-anniversary celebration, they chose to recognize the exceptional commitment of individuals, organizations, and corporations who serve as champions for children and those who work on their behalf. Dennis Embry has devoted a lifetime of service on behalf of young children and their families.

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