Source: The New York Times.
Liberals and conservatives often disagree about the causes of poverty and other social ills. Broadly speaking, liberals point the finger at structural factors and advocate for policy changes, while conservatives look to individuals and families and favor behavior changes. Clearly, both points of view have validity. But what’s often overlooked is what lies between these two poles — communities and neighborhoods — and the value of focusing on this middle zone.
Last week, I reported on the work of the Family Policy Council, an initiative established in Washington State in the 1990s to stem a rise in youth violence. Policy makers recognized connections between youth violence and several issues: child abuse, domestic violence, placement of children outside their family homes, dropping out of high school, teen pregnancy, youth substance abuse and youth suicide. They gave the council a modest budget and a statewide mandate, so the organization focused on helping counties across the state establish their own community networks to advance integrated solutions.
The council operated for close to two decades before its budget was cut in 2012, but the work it catalyzed continues to ripple out across the state (and is being carried forward through a new public-private initiative). Last week, researchers released the results of a three-year study examining five community networks in Washington. What they found was striking: Some communities had successfully reduced the “long-term social, emotional and physical problems related to abuse, neglect and other adverse childhood experiences.”
“These are very hard issues to solve, and some of these efforts have been successful with pretty slim resources, just a hundred thousand dollars or a few hundred thousand dollars,” said Natalya Verbitsky-Savitz, the principalinvestigator on the study. The reason for the outsize impact, relative to resources, was the way networks leveraged resources by engaging partners within the community, she said.
The study found improved graduation rates in Walla Walla, reductions in prenatal smoking and alcohol use by mothers, and fewer infants born at low or very low birth weights in Skagit, and reduced alcohol use among teenagers in Okanogan, Verbitsky-Savitz said. What’s more, the communities had built up their own capacity to create productive partnerships and coalitions, establish shared goals, and use evidence-based approaches to make progress — although all of them needed help to learn how to make good use of data, mobilize residents and sustain themselves.
The notion that a modest investment in a “community network” can chip away at entrenched social ills seems hard to believe. But the main lesson of the Family Policy Council is that when local citizens acquire the capacity to work together in smarter ways, communities change. “We have to expand leadership to include the people who are most affected by problems,” said Laura Porter, who directed the council from 1998 to 2013. “Not just advice, but real leadership. People will step into that space, and what happens is you get this expansion of resources.”
In Wahkiakum County, in the southwestern corner of Washington State, for example, the community network decided to focus on youth drinking and driving after the tragic death of a child. Residents came together, decided they would no longer tolerate the behavior and developed a strategy with the police. The rate dropped. Then they focused on reducing violence between intimate partners and built a shelter for victims. “You literally had to walk through the police station to get to the shelter,” recalled Porter. It was a way of making clear “that they were going to protect women,” she added.
In Whatcom County, just south of the Canadian border, residents banded together and connected with child service agencies to make sure that when children were removed from their parents’ care, a foster home was available in the same neighborhood; this allowed the youngsters to remain close to family, friends and siblings, something vitally important for their well-being.
In Adams County, a rural area in eastern Washington with a high rate of youth violence, Barbara Anderson, the director of the community network, galvanized the community to take action. “I started seeing improvements in their youth violence rates,” Porter recalled, “so I went out there and shadowed Barbara for two days to see what she was doing.”
Anderson took her along to an onion packing plant, where she talked with workers on the production line. Porter remembers how Anderson interacted with workers. For example: “‘Don’t you have a third grader? I’m really worried about violence and how we can keep our kids safe. What can we do?’”
Later, they traveled around the county, and Anderson asked people like bank tellers, waitresses and cooks what should be done to stop the violence, Porter said. “She categorized all the ideas. Then she went online and looked for programs and started writing grants. When she got them, she would go back to the onion plant: ‘Mary, we got the money for the Boys and Girls Club, this was your idea, so now you have to help.’ And that’s how they brought in all these programs for youth and the leadership expanded.’ ”
Anderson is now retired. When I shared Porter’s recollections with her, she commented: “It’s all true, but it sounds so much more glamorous than it was. It really was just part of a community effort. We had a great team of people who didn’t like the high rates of juvenile violence, delinquency and recidivism, and we wanted something done about it.”
Everywhere she looked, Porter saw that people at the county or neighborhood level had the capacity to lead changes. But what increased everyone’s power was the data and understanding that were emerging about the underlying causes of the social problems they were confronting.
In the late 1990s, two researchers, Vincent Felitti and Robert Anda, sought to examine the effects of trauma among the young, or so-called adverse childhood experiences. In what is now known widely as the ACE Study, they surveyed 17,000 mostly white, middle-class residents of San Diego who were enrolled in Kaiser Permanente, an H.M.O., inquiring about 10 categories of adversity, including physical, sexual or emotional abuse or neglect. They asked participants if they had witnessed violence against their mother, or if a parent had been an alcoholic, or had a mental illness or been incarcerated, then assigned each an “ACE score” of zero to 10.
What they found was alarming. Compared with people with ACE scores of zero (about a third of study participants), people with ACE scores of four or above (about an eighth of the total) had substantially higher risks of failing in school, abusing alcohol or drugs, having sex as a teenager, becoming depressed, committing suicide, and developing a chronic illness.
Barila had been bringing residents and leaders together across Walla Walla county for years. In some of the harder hit areas, such as the neighborhood known as Edith & Carrie, next to a state penitentiary, she had walked house to house, knocking on doors. “How might we be able to help connect the neighborhood better?” she would ask, and “What changes would you like to see?” Like the residents of the Highlands, in Cowlitz County, whom I reported on last week, the first thing people asked for was better lighting.
“Starting where they were, we built trust and relationships,” said Barila. In 1998, she organized a Children’s Forum, now a biennial event, to examine the community’s priorities. That led to the establishment of a youth community center, which was soon drawing up to 200 young people a night, and a mentoring organization, the Friends of Children of Walla Walla. The community network tapped leadership from local residents, who built playgrounds and revamped parks.
Learning about the ACE study was an awakening, Barila said. It gave her fresh insight into many youth problems, from drop outs to drug use to violence. One of the central teachings from the research is that negative behaviors are directly related to the accumulation of trauma in childhood. “We have to learn,” she said, “to shift the question from ‘What’s wrong with this kid?’ to ‘What can I do to understand what’s triggering him?,’ Or: ‘What’s triggering me, so I can remain calm and consistent and reliable?’ ”
In 2008, Barila invited Robert Anda to present his research to the community; then she continued to bring together leaders to discuss its implications. After state funding for the community networks was cut in 2012, Barila established a new organization, the Children’s Resilience Initiative, and has since led more than 1,000 presentations about the effects of adversity and what works to build resilience, connecting with people working across many sectors. “They’ve brought awareness about ACEs into law enforcement, state prisons, state housing, parent advocates, health, education, and are now ramping it up to say let’s set goals to get all the organizations in our community to become trauma informed,” said Jane Stevens, editor of an excellent news site that covers this issue,AcesTooHigh. (For a detailed account of the changes in Walla Walla, see Stevens’s report here.)
Today, virtually everyone involved in social services in the county is schooled in the research on adversity, and 40 percent of residents are aware of the key concepts. The challenge is embedding the knowledge in public systems that have long focused on punishment as a deterrent for misbehavior. One leading model is Lincoln High School, an alternative school for youths with behavioral challenges. In the year after Lincoln shifted to a fully trauma-informed approach in 2010, its suspension rate dropped by 85 percent. From 2009 to 2014, the graduation rate increased from 44 to 78 percent. (The story of the school’s transformation is recounted in the moving documentary “Paper Tigers,” directed by James Redford.)
“Every day, we read about violence, suicide and overdoses in the news,” says Porter. “We now know that these things are largely driven by ACEs. We’re the first generation that actually has the knowledge to drive these rates down. And the most powerful leverage point is helping parents learn how their experiences have shaped them — and that they are normal. Just recasting that story is powerful. Parents with high ACE scores have the most power to lower it for the next generation. When I talk to parents about this, they get teary-eyed.”
Next week, part three.