Chris Uggen's Blog: December 2012

Tuesday, December 18, 2012

a broader-based response to shootings

I've been reluctant to write about the terrible events at Sandy Hook Elementary School because the wounds are still too fresh for any kind of dispassionate analysis. As a social scientist, however, I'm disappointed by the fear-mongering and selective presentations of the research evidence I've read in reports and op-eds about Friday's awful killing.

Such events could help move us toward constructive actions that will result in a safer and more just world -- or they could push us toward counter-productive and costly actions that simply respond to the particulars of the last horrific event. I will make the case that a narrow focus on stopping mass shootings is less likely to produce beneficial changes than a broader-based effort to reduce homicide and other violence. We can and should take steps to prevent mass shootings, of course, but these rare and terrible crimes are like rare and terrible diseases -- and a strategy to address them is best considered within the context of more common and deadlier threats to population health. Five points:

1. The focus on mass shootings obscures over 99 percent of homicide victims and offenders in the United States. The numbers should not matter to parents who must bury their children, but they are important if policy makers are truly committed to reducing violent deaths. There are typically about 25 mass shootings and 100 victims each year in the United States (and, despite headlines to the contrary, mass shootings have not increased over the past twenty years). These are high numbers by international standards, but they pale relative to the total number of killings – about 14,612 victims and 14,548 offenders in 2011. In recent years, the mass shooters have represented less than two-tenths of 1 percent of the total offenders, while the victims have represented less than one percent of the total homicide victims in any given year. We are understandably moved by the innocence of the Sandy Hook children, but we should also be moved by scores of other victims who are no less innocent. There were 646 murder victims aged 12 or younger  in the United States in 2011 alone -- far more than all the adults and children that died as a result of mass shootings.

2. The focus on mass shootings leads to unproductive arguments about whether imposing sensible gun controls would have deterred the undeterrable. As gun advocates are quick to point out, many of the perpetrators in mass shootings had no “disqualifying” history of crime or mental disorder that would have prevented them from obtaining weapons. And, the most highly motivated offenders are often able to secure weapons illegally. Even if such actions do little to stop mass shootings, however, implementing common-sense controls such as “turning off the faucet” on high capacity assault weapons, tightening up background checks, and closely monitoring sales at gun shows are prudent public policy. But the vast majority of firearms used in murders are simple handguns. I would expect the no-brainer controls mentioned above to have a modest but meaningful effect, but we will need to go farther to have anything more than an incremental effect on mass shootings and gun violence more generally.

3. The focus on mass shootings obscures the real progress made in reducing the high rates of violence in the United States. I heard one commentator suggest that America had finally "hit bottom" regarding violence. Well, this is true in a sense -- we actually hit bottom twenty years ago. The United States remains a violent nation, but we are far less violent today than we were in the early 1990s. Homicide rates have dropped by 60 percent and the percentage of children annually exposed to violence in their households has fallen by 69 percent since 1993. We can and should do better, of course, but these are not the worst of times.

4. The focus on mass shootings exaggerates the relatively modest correlation between mental illness and violence. Those who plan and execute mass shootings may indeed have severe mental health problems, though it is difficult to say much more with certainty or specificity because of the small number of cases in which a shooter survives to be examined. We do know, however, that the correlation between severe mental illness and more common forms of violence is much lower -- and that many types of mental health problems are not associated with violence at all.

5. The focus on mass shootings leads to high-security solutions of questionable efficacy. Any parent who has attempted to drop off a kid's backpack knows that security measures are well in place in many schools. Rates of school crime continue to fall, such that schools are today among the safest places for children to spend so many of their waking hours. In 2008-2009, for example, only 17 of the 1,579 homicides of youth ages 5-18 occurred when students were at school, on the way to school, or at school-associated events. Of course we want to eliminate any possibility of children being hurt or killed at school, but even a 2 percent reduction in child homicide victimization outside of schools would save more lives than a 90 percent reduction in school-associated child homicide victimization. While every school must plan for terrible disasters in hopes that such plans will never be implemented, outsized investments in security personnel and technology are unlikely to serve our schools or our kids.

In the aftermath of so many deaths I am neither so cynical as to suggest that nothing will change nor so idealistic as to suggest that radical reform is imminent. I'm just hoping that the policy moves we make will address our all-too-common horrors as well as the rare and terrible events of the past week.

Monday, December 10, 2012

demolition derby and the social construction of injury

When people ask why I pursued or persist in sociology, I sometimes say that the world just makes no sense without it. With a few basic concepts, some systematic observation, and a little analysis, however, we can at least begin to fathom the unfathomable. Today's new TSP feature on genocide by Hollie Nyseth Brehm offers a grim example, but my favorite physical therapist offered another illustration this weekend. She had just attended a conference on understanding pain and injury -- a big part of any PT's job -- and came across some cool studies on the social construction of these phenomena.

My favorite new example is Neck Pain in Demolition Derby Drivers by Alexander Simotas and Timothy Shen in Archives of Physical Medicine and Rehabilitation. In the general population, about 10 percent of people who have a car collision will develop chronic severe neck pain. Doctors Simotas and Shen surveyed 40 demolition derby drivers, who had undergone a median of 1,632 lifetime collisions at an average estimated speed of 26 miles per hour, 55 percent of which were rear-end, with no special safety equipment. Yet only 3 of the derby participants (7.5 percent of the sample) reported even mild chronic neck pain and none reported moderate or severe chronic pain.

 In short, the "accidents" experienced on the street appear to exact a much greater toll than those at the county fairground, even though the events involve the same biomechanics: an "acceleration-deceleration mechanism of energy transfer to the cervical spine." The sampling strategy and response rate are not ideal in this study, but I suspect that the basic pattern of results is likely to hold up to a more rigorous analysis.

 In my view, the question is less about whether these injuries are socially constructed than about the relative contribution of various social determinants. From a sociolegal or economic perspective, one might look to financial incentives (e.g., it appears that chronic neck pain after car accidents is far less prevalent in nations (such as Greece) where victims receive little financial remuneration). From a sociology of sport perspective, one might explain the denial of injury among participants in terms of the culture of risk surrounding contact sports. Finally, the fact that offending drivers (the "hitters") experience far fewer symptoms than the targets (or "hittees") suggests that playing social roles as aggressors or victims might also be important. The emotions of the events are obviously quite different as well, with derby likely invoking fun or thrilling feelings, while car accidents tend to invoke fear or worry.

 Of course, the fact that whiplash injuries are socially constructed doesn't mean that myriad other physiological and  psychological mechanisms are not also in play. In fact, my personal explanation for these results is a biopsychosocial theory developed to account for my immoderate pie-eating behavior:  anything this wonderful has just got to do a body good.

Thursday, December 06, 2012

crime, community, and clostridium difficile

When you take a course of antibiotics to zap a bacterial infection, you can also lay waste to a lot of healthy bacteria that your body really needs. And once you’ve wiped out the healthy flora in your gut, you’re vulnerable to nasty bacteria such as Clostridium Difficile, which brings symptoms ranging from severe diarrhea to life-threatening colon problems. Though I’m skeptical-bordering-on-terrified of organicist arguments in sociology, hearing a talk by Minnversity colleague Mike Sadowsky on “C. diff.” brought some parallels in social research to mind. Before proceeding, I should acknowledge the obvious “ick factor” in this post, but bear with me a moment.

As Dr. Sadowsky explained, one successful treatment for recurrent C. diff infections involves fecal transplantation – essentially implanting a donor’s stool sample in a recipient to repopulate the healthy colonic flora and restore bacterial balance. Within a very short time, the donor’s gut flora is typically brought back to healthy equilibrium. Now that might sound icky (even when said sample is freeze-dried), but it is way less icky than surgical treatments like colectomy. What really got me thinking was my colleague’s big-picture conclusion that much of the past century of U.S. research in this area had been devoted to isolating and zapping the bacterial delinquents, while much of the next century seems devoted to restoring the whole to healthy balance. And, if I understand things correctly, it turns out that the latter approach is actually a lot simpler than specifying, modeling, and manipulating the complex interactions among myriad bacteria that may be “good” or “bad” depending on the particular combination and circumstance.

Of course, certain Ghosts of Sociology Past, Present, and Future think about societies in quite similar ways. No, people aren’t bacteria and communities aren’t intestines, but you don’t have to be a functionalist or an organicist to draw some basic analogies. For example, as William Julius Wilson points out, it is the social isolation of the urban poor that exacerbates the challenge of redressing imbalances and (re)building the institutions needed for basic community functioning. More generally, social interventions, like medical interventions, sometimes bring their own pathologies or iatrogenic effects. Like the overprescription of antibiotics behind the apparent C. diff epidemic, the grand American experiment with racialized mass incarceration, has had untold effects on individuals, families, and communities that are only now coming into focus.

I won’t speculate here about how to restore social systems to healthy balance, but some of us try to at least consider such questions in our research. In some cases, this involves calling out the problems associated with attempts to isolate and zap our more delinquent members. In others, it involves identifying and assessing viable alternative approaches to reducing harm -- regardless of any potential "ick factors" that might be associated with our research.

Wednesday, December 05, 2012

ass over teakettle

I can't really explain it, but Minnesotans get all cozy and romantic when the temperature drops. Blame it on the sweaters and hot chocolate, I guess. As for outdoor activities, I'm a big proponent of winter running. I tell newbies two things: (1) it is pretty unlikely they'll freeze to death; and, (2) they might actually survive a slip on the ice -- if they'd just learn to fall correctly. I was going to write a quick post on the latter point, but my new cranberry joy diffuser inspired some weapons-grade bad poetry. Time of the season, I suppose.

Ass over Teakettle

When the sun drops at 4:40,
And the roads start freezing up,
Winter runners all fall down,

The ice will flirt and tease,
Until you stretch your stride too far,
Or look where you’re not going,
And then you’re going down.

But in that slide-whistle moment,
With feet so strangely suspended,
Don’t waste your cartoon star turn,
Feeling ridiculous.

And never stiff-arm a frozen street,
With bony fingers and soft palms,
Force equals mass times acceleration,
And hands equal twigs plus crepe paper.

Just loosen up and tuck it in,
Trust your butt and shoulders,
And the ground might catch you gently,
Like a rec-room beanbag chair.

No skin off your nose,
(Well, maybe just a little),
But it beats those indoor treadmills,
High-tech hamster wheels.

Yes! Winter runners all fall down,
Breathing sweet cool air,
In the silver-blue light,
Between stars and snow.