(13) Anthropology paper Perrin combines ACE studies and income inequality research

Just because there is a lot of diversity in race, class, and gender in California does not mean that social suffering does not exist, and that inequality is not rampant. Deemed as social categories race, class, and gender are the predominate ways people make assumptions of others by how they behave and think. Connecting with one another is often based on status, therefore it is not always easy because individual identity is often assumed through the lens of a dominant and subordinate race, class, and gender binary system. Consequently, the Latin gang girls experienced structural violence in the story home girls, and their identity was inflicted, because of the structural barriers and social inequalities that confronted them. Studies performed by Nadine Burke Harris a renowned Adverse Childhood Experience (ACE) expert has found that the level of adversity a child experiences, while they are in their developmental years is a factor that can determine a number of learning and behavioral difficulties, and if not addressed can lead to long term health consequences. Two different research paradigms- income inequality, ACEs show that people share the same type of behavioral issues, and that these issues are only prevalent in more unequal countries. These issues are the kind that lead to single mothers, broken homes, and commonly cause trauma at the transgenerational level. Ace studies find that vulnerable individuals raised in unequal high stress environments are susceptible to negative health consequences from an exasperated maladaptive stress response. This paper looks through this lens at variables of structural violence and empowerment/identity at the intersection of race, class, gender in relation to human development and the stories “Righteous Dopefiends”, and “The Home Girls”. One short coming in using social constructs to understand race, class, and gender

PEREZ 2 indifferences is that people often fail to consider what the experiences and conditions were that a person had to contend with in their developmental years. Identifying and being socialized is an important part of the development process. Parents at a higher socioeconomic status (SES) levels foster negotiation and self- sufficiency skills in their children, which children in poorer households have less supervision, lower levels of autonomy and fewer school related activities as related to skin color and social mobility (Campos-Vasquez, 2019). Social suffering and being raised in a negative environment are factors that may lead to of adverse childhood experiences (ACE) and toxic stress. The “Righteous Dopefiends” and the “Homegirl’s” story may serve as an example of how environment, nurture and being socialized during childhood may affect them in their later life. The majority of the Righteous Dopefiends had the worst childhood experience. Carters Father beat his mom, Tina’s mom whipped her and told her that she did not want her, and Sonny experienced the streets before he knew what they were. Sonny had a stable childhood but being low status class societal conditions exposed him to drugs and crime. All ethnicities are exposed to ACE, and the higher the ACE score the more apt an individual is for mental health issues The Edgewater homeless became homeless drug addicts that had bad experiences in their childhood in which they may have never recovered. The Latina gang girls at San Juan High School (SJHS) had experienced structural violence, but they were able to stay strong and relinquish their identity through their friendship. The Latin gang girls had problems to deal with at school being an ethnic minority in a socially dominant white school, and they used a tough gang girl image to balance out the negative effects of symbolic violence.

PEREZ 3 . Pierre Bourdieus concept of symbolic violence links immediate practices and feelings to social domination (class notes). An example of symbolic violence is how the Latin gang girls are interpreted as the subordinate class at SJHS, so their reaction may be to blame themselves for this, therefore they act Macha. Being discriminated based on differentiation of class is stressful. Acting “Macha” is one way for them to identify as tough and confront the social domination that haunts them every day. The level in which they interpret this social threat is high, which may give reasoning to why they adjust their identity to portray a characteristic that, in contrast to gender binary norm of female. Identifying and fitting in to your general surroundings can be tough in the face of inequality.” Human beings and their societies are deeply interrelated, and the actions we take have enormous ramifications for the lives of others” (Robert N. Bella 1985, 284). How one interprets social class inequalities may affect their self-image/identity.” A home girl T Rex said, “being a gang girl is not a way to act but is a way to get respect and stand up for yourself” (Mendoza-Denton 2008, 169). The Latin gang girls social pain was high and they faced these inequalities the best they knew how. The adversity (i.e. structural violence) that the Edgewater homeless experienced in their societies and childhood experiences catapulted them into a tunnel of endless hope and pain in which they were unable to recover. Development can be derailed due to toxic stress, which makes it important to be aware of difficulties that exacerbate pain, crises, and emotion, especially when someone is experiencing adversity when they are young. METHOD . I used a correlational study approach comparing two studies and found a high

PEREZ 4 prevalence of connectivity to social issue that the lower sector of the social hierarchy experience. Upon researching these studies I hypothesized: If the behavioral issue/social problems (alcohol and drug use, Teenage pregnancy, teen paternity) are a symptom of toxic stress that contribute to the problem, then the environmental conditions (i.e. social, developmental) that create the toxic stress need to be addressed to begin resolving the problem. I understand correlation does not imply causation. This hypothesis is like a proposal for action, because if we can understand it then it gives us the tool to begin fixing it.

The transcription for Dr. Nadine Burke Harris was from a conference that she did in Scotland (first ACE aware nation) called ACE-Aware Nation Conference- The science of ACE’s is fundamentally hopeful (Burke, 2018).

The original study for Adverse Childhood Experience’s was done by Kaiser Permanente and the Center for disease Control in 1995 and had 17,500 participants. Appendix A share the specifics ACE information. The Income Inequality studies are don by Richard Wilkinson a leading research specialist in this field. Original Ace study N= 17,337 Emotional abuse 10.6% Physical abuse 28.3% Sexual abuse 20.7% mother abused 12.7% Household sub. abuse 26.9% mental abuse 19.4% Parent sep. divorce 23.3% incarcerate fam mem. 4.7% Emotional neglect 14.8% Physical neglect 9.9% Figure 1 statistics from the original ACE. Info from U.S. Center of Disease Control

PEREZ 5

Outcomes of ACEs affect- alcoholism and alcohol abuse, COPD, depression, health-related quality of life, illicit drug abuse, heart disease, liver disease, poor work performances, financial stress, risk for intimate partner abuse, multiple sexual partner violence, STD’s, smoking, suicide attempts, unintended pregnancies, early initiation of smoking, early initiation of sexual activity, adolescent pregnancy, risk for sexual violence, poor academic achievement. I also used info from Richard Wilkinson and Kate Pickett book The Spirit Level (Richard Wilkinson, 2010). Psychosocial Risk Factors stress in early life, low social status, and weak social connections. The factors connecting the ACE & income inequality are the psychosocial issues. The income Inequality study tells us about inequality affects social status The ACE study Biological findings indicating stress becoming maladaptive is the underlying mechanism that lets us know what we can do. Inequality studies show to have equality have to lower the overall incidence of stress problems circular behavioral from adults. Must lower these statistics in Fig. 1 this begins practicing ACE awareness 7 the goal stop collective trauma today by working on these and all issues that cause stress and transgenerational trauma for the poor. –INTERVIEW-- Leading thinker of adverse childhood experiences can this count as ACE literature rev.? We turn over the conversation to Dr. Nadine Burke Harris to help us better understand the devasting effects of Adverse Childhood Experiences. -Literature review of ACE- Transcription: . Prompter: What are adverse childhood experiences? . Dr. Nadine Harris Burke: A tool used to test people for the adversity the have experienced. Adversity tests: abuse- physical, emotional, sexual.

PEREZ 6

Neglect- physical, emotional. Household-mental illness, mother treated violently Prompter: Who is affected by Ace scores? Dr. Nadine Harris Burke every ethnic group is affected- black, white, Hispanic, Asian, Pacific-Islander results are similar across all the ethnicities.

Prompter: Are there any societies that show a higher prevalence of symptomology?

Dr. Nadine Harris Burke: Results of the studies are similar between ethnicities, but people from poor lower status suffer at a higher rate due to the environmental factors (adversity) that they contend with.

Prompter: why should we be concerned?

Dr. Nadine Harris Burke: There are a lot of reasons we should be concerned. High ACE scores result in learning and disabilities in children is often toxic stress, but often misdiagnosed with ADD/HD and wrongly medicated. The study indicates that behavior and learning difficulty are due to factorial adverse childhood experiences.

Prompter: What is the clinical outcome of too much toxic stress?

Dr. Nadine Harris Burke: The outcome is not good if these disorders are not caught early. public health problems from this disorder connects to development to adulthood issues of mental health conditions due to a maladaptive stress response- means the HPA stress response system is maladaptive from being in the stressed continually- inhibited frontal cortex- lower level executive functioning increased level of impulsivity, amygdala (emotional center of brain is overactive), Nucleus accumbens (pleasure reward center) imbalance. There real neurological concern being the altered neurological function. A child with too much stress has behavioral and learning disorders these biological irregularities have already set in.

Prompter: Since all ethnicities have similar results of ACE scores are there any

other groups in society that experience adversity any more than any others?

PEREZ 7

Dr. Nadine Harris Burke: The ACE study has 5 familial and 5 personal categories totaling ten questions regarding adversity. There are many other factors to condition an adversity effect (i.e. bullying, racism, financial struggles). See appendix A.

Prompter: This suggests an environment condition affects lower class status individuals, because they are affected at a higher rate due factors experience in their daily living.

Dr. Nadine Harris Burke: My medical clinic is in the worse neighborhood in San Francisco. Statistic presented in this population; 2/3 of my patients have 1 or more ACE score, 1 in 8 of my patients have four or more ace scores, and these kids are 32% more likely to experience behavioral and learning disabilities. Kids with 0 ACE scores from the same population are only 3% likely to have behavior or learning disabilities.

Prompter: What social problems are correlated to children with four or more ACE scores?

Dr. Nadine Harris Burke: The level of adversity varies, but these studies clearly indicate behavior problems lead to alcohol and drug use teenage pregnancy, early inception, teen paternity are related to presentation of four or more ACE scores based on outcomes of adverse childhood experiences.

Prompter: it is alarming that too much toxic stress can cause behavioral issues at this complexity, and if not corrected can determine an outcome such as negative health consequences.

Dr. Nadine Harris Burke: Neurological as well- Multi-systemic alterations- long term changes to fight or flight response, overactive fear response, changes in brain structure and function can interfere with learning, changes to brain biology to increase risk of addiction/high risk behavior.

Prompter: Thank you (Burke 2018)

Literature Review: Income Inequality (inequality) correlated to Adverse Childhood Experiences: Harris deems that behavior and learning issues are only the symptoms, that the kids are not the

PEREZ 8 problem. That the problem is toxic stress, because the many variables of adversity that they are confronted with in their daily lives. This sheds light, that social problems caused by stress continue to compound inequality for those at the bottom, and these problems contribute to the underlying mechanism for their not getting ahead generation after generation. It raises awareness that social constructs that stigmatize the lowest social hierarchy are real, and what are implicated as behavioral failures are not necessarily failures, but symptoms of exacerbated stress. If the behavioral issue/social problems (alcohol and drug use, teenage pregnancy, teen paternity) are a symptom of toxic stress that contribute to the problem, then the environmental conditions (i.e. structural violence) that create the toxic stress need to be addressed to begin resolving the problem. Since this is a multi-faceted problem and we are aware that toxic stress is the underlying mechanism then it is necessary to remedy as many factors as possible that add to toxic stress. Remedy the behavior before difficulties of maladaptive stress become a permanent neurological impairment. . “Further investigating issues of inequality, research performed by” (Wilkinson, 2010) show observable correlations to the same behavior problems/social issues that Dr. Harris Burkes ACE research have shown. The Prevalence of high incidence of behavioral/social issues problems between these two studies are (i.e. alcohol and drug use, teenage pregnancy, teen paternity) revealing. Behavioral problems/social issues are related to the of poor, however these behavioral problems/social issues are not prevalent to that of the more equal societies. The income inequality studies show the same behavioral issues as people with high ACE scores are only prevalent in more unequal countries, and that these issues are the kind that lead single

PEREZ 9 mothers and broken homes these issues continually cause trauma at the transgenerational level. The outcome of the ACE studies exemplify that the scores between all the multi- ethnicity- black, white, Hispanic, Asian, Pacific-Islander scores were similar. This is intriguing because the prevalence of behavioral problems/social issues in inequality leans more to those lower on the social hierarchal ladder (black, Hispanic). This raises awareness that environmental conditions in lower economic societies play a big role in the higher accumulation of behavioral problems/social issues. The ACE study is reliable there is an additional screening for other possible forms of trauma (appendix A-2). This is one conflicting outcomes of ACEs study that equality studies helps to unfold. The equality study correlates the same behavioral problems/social suffering as ACEs and reports that these issues are only prevalent in nations with high inequality. Analysis It is apparent that a systemic inequality exists and contribute to behavioral problems/social issues that these folks in the lower societal position. This indicates broad societal failings that neglect correcting environment/social conditions that lead to toxic stress and collective trauma at the transgenerational level. One way to dehumanize an individual or a group is to deny the reality of their experiences (Collins 1995, 4o). The majority fail to recognize the social suffering of black people and do not see class differences for what they are. It is symbolic violence to see personal character flaws when inequality and ACE studies both show that broad societal failings, and social inequality are underlying factors of their stress condition. Poor people often blame themselves and accept the stereotype that they have moral

PEREZ 10 flaws. “But poverty reflects broad societal failings more than individual shortcomings” (Johnson, 2014, 103). What is needed is to find equilibrium in the complexities of indifference towards unity with those towards the bottom of the hierarchal social order of indifference. Are tensions (biological stress response) a two-sided coin of empowerment/identity that cause distress that may instigate racial disequilibrium? With the relation of these issues to high ACE scores and inequality, makes it hard not to ponder the pecking order in society and how subjectivities of the power and privileged are handed down and impressed among the lower order. Many of these variables are hard to uncover, but one commonality, surely related to mankind, society, and how race/class affects us is human emotion, identity, and how one identifies with those around him. ”Currently, we are all enmeshed in a complex web of problematic relationships that grant our mirror images full human subjectivity, while stereotyping and objectifying those most different than ourselves” (Collins 1995, p. 35). If America did not have such a high level of indifference between the ordinate vs subordinate it may not have such prevalence of empowerment identity issues. How race/class inequalities are assumed and presupposed onto others can place a socially validating or invalidating effect on their empowerment/ identity. These effects are also transposed at the neurological level, so being socially validated, or not affects human beings at the biochemical level of the (positive or negative) social reinforcement system. The coincidence is that thinking and balancing emotions are the same brain functions that get altered inhibited (thinking) or exasperated (emotion) when the stress response is activated. One’s empowerment /identity will be reinforced based on their likes and dislikes

PEREZ 11 (habitus), in accordance to the persons views and opinions. The views people hold of the ordinate and subordinate class may be opinions, but in reality these opinions at the conscious level are a derivative of belief, and how it is reinforced (feel bad or good) at the biological level depends on if you feel your habitus if reinforced or not. Balance is an emotion/thinking process. Race, class, gender relations can be challenging, therefore it may help to be aware of why indifference and status can make some people sensitive to these issues. . The poor seem to have the triple whammy against them. Being at the bottom of the social hierarchy is probably a small worry for them over the factors in life for example, structural violence and environmentally unsafe conditions. Analysis of the income inequality studies (appendix B) was the recognition of complexity of social problems that exist and how important early intervention is to prevent maladaptive neurologic function that leads to bad decisions. Correlations in these studies revealed (from equality statistics) that people often become a victim of their environment. From ACE studies I learned that people who suffer inequality act out behaviorally and that implication from these behaviors lead to long term consequences that affect the next generation. For example, teen pregnancy that leads to a single mom then a neglected child (lack of resources) and then the circular problem repeats itself. These folks continue to suffer structural violence in the institutionalized criminalization (i.e. punitive sentencing, high incarceration rates) for this sector of society which also contributes to their lack of family structure. If the behavioral implications are symptoms then broad societal issues may exacerbate the problem for example, professional agencies that do not see symptoms, but condemn a behavior. Structural violence if these people have disparate access to resources,

PEREZ 12 and it is important incur all circumstances of development, rather than neglect to offer rehabilitation where it is needed (multi-dimensional approach). The point in the long run if behavior is a symptom the issue needs to be uncovered, because healing (i.e., shame, toxic stress) any foundational problem of the issue is control, because the behavior will be resolved and not exacerbated. . “This research shows that societies with high income inequalities between the rich and the poor have many issues including issues with trust, mental illness (including alcoholism and drug addiction), homicides and other social problems” (Richard Wilkinson, 2010, p. 19). Thinking along the lines of prejudgment is the cause of many of the social problems that are already prevalent in society today. It is also a step of one’s habitus neglecting the capacity of the brain for rational logical thought which promotes healthy brain function. The ACE study finds profound evidence that maladaptive brain circuitry could result from toxic stress. It may help explain evil acts, because anytime an atrocious event or hate evolves it is most definitive to be invigored through one’s habitus and emotion. Harris (2018) specifies actions of the brain that usually give us control become a loss of control. The frontal cortex becomes inhibited (lack of impulse control), the amygdala is unstable (emotional dysregulation), and the nucleus accumbens neurotransmitter imbalance (pleasure reward center) leads to risky behavior. Ace scores and the criteria that tests for extra environmental stressors (appendix A) are a very important tool to use to verify if you are a candidate for toxic stress, or if behavior and learning disabilities are stress related. Dr. Harris Burke informs us that once symptoms of toxic stress appear if not corrected biological impairment happens quickly and is difficult to correct. . PEREZ 13 . The biological mechanism for stress response helps in an emergency, but when this system become overextended to the point of being maladaptive it wreaks havoc and disrupts the balance of daily living. What is causing the stress is the problem that needs to be fixed. The combination of the ACE and Equality studies indicate the relevance of these factors and that multi- ethnical in nature and that people at the bottom of the social hierarchy of systemic inequality are most susceptible. “Many join gangs to escape their abusive family but pay a hardship (social injury hypothesis) of sexual stigmatized” (Mendoza-Denton 2008, 162). The Edgewater homeless had terrible childhood experiences which delayed growth and was a factor that prevented them from developing to live a healthy functional life. They became homeless drug addicts with the main satisfaction in life coming from heroin use. Everyone complained hated seeing these folks they were the rock bottom eye sore in society, nonetheless a product of society. Sonny was the only one mentioned in the text that came from a stable family, yet experienced negative environmental conditions in his society he suggested later in a failed after school program that he wish he could have continued with. This is an example of how the environment vs. healthy nurturing plays a negative role in one’s development, and we will here how the structural violence of institution setting failed him. Policy and Initiative suggestions: . Societal problems will never mend till we mend our people. Understanding issues that cause stress and that toxic stress can be indicated in people with high ACE scores is a tool that can be used for enhancement and quality of life. Sonny an Edgewater homeless had a stable

PEREZ 14 family but interactions of bad environment of being on the street when younger, and he was drawn into a local peer group. He bragged later in life of an after school program that he enjoyed because he built things, but funds for this program and social service’s were cut to support” Nixon’s war on drugs” (Philippe Bourgois, 2009, p. 162). Nixon’s authoritarian rule was extreme and destructive. The scenario Sonny explained is all too common in symbolic and structured violence overlooking benefits that help build the lower status people. That is not on the agenda, this would reflect flexibility of empowerment and the priority of one’s habitus. To be more open we must put generalizing and confirmation bias aside to see root cause scenarios, and not be fooled by behaviors that are symptoms of another problem. A leader that thinks out of the box and seeks a wider range of possibilities may have a better outcome. The nature of this multi- faceted approach is more flexible, and more resilient to stress. The mindset that see’s the importance of early intervention is more apt to take ACEs and inequality more seriously. Every situation is unique and individualized. For example, if someone has high ace scores then finding and addressing variables that lead to stressors in their specific environment is necessary. Intervention for people with high ACEs is often recognizable through behavior and learning difficulties. Therefore, social service agencies should practice ACE awareness. They can do this by sharing ACE resources and protocols for folks with perceived behavior problems. A derivative of early intervention is awareness, and to have measures in place to test those suspect of high ACE scores. Therefore, the initiative I suggest is that California should become the first ACE aware state. The actions necessary are as follows: Due to the extremity of societal conditions, the detriments of toxic stress, and the ability for

PEREZ 15 ACE testing to recognize and offer antidote to these conditions I suggest the following policy. That ACE testing should become a part of every medical plan. Implement regular screening and testing. Schools should also be aware of any person that is exhibiting behavior, and/or learning disabilities, and have measures in place to test and treat the foundational problems that are creating stress for the individual. Social services should be provided free of charge for all ACE situations that arise for youth. . I am passionate in hope that ACE and equality studies can remedy the transgenerational downfalls for those that struggle, and see America become a more equal nation. Our habitus forms greatly as we develop in life, but that does not mean it stops here. A disciplined thinker becomes familiarized with habitus that leads to social injustices and is always reasoning, rationalizing, and learning to form habit, character, and destiny not just for themselves but justice for others as well.

APPENDIX A

What Is the ACES Screening?

The ACES test that we use in California screens for 10 forms of childhood trauma—five personal, five familial.

Personal Traumas

• Addiction

• Domestic violence

• Incarcerated family member

• Mental illness

Divorce or abandonment

• Physical abuse

• Verbal abuse

• Sexual abuse

• Physical neglect

• Emotional neglect

Familial traumas:

• Addiction

• Domestic violence

• Incarcerated family member

• Mental illness

• Divorce or abandonment

The ACES test is scored 1 through 10, with each type of trauma experienced counting as one point. An individual with alcoholic father and an early-life history of verbal abuse and emotional neglect would score three on the ACES screening.

APPENDIX A CONTD.

Life is too darn short to not go all out and try to make the Best of it C’MON we got this

Nobody wins unless we all win

Research is very consistent with these results. For example, one wide-ranging found that individuals with an ACES score of four or higher are:

• 1.8 times as likely to smoke

• 1.9 times as likely to become obese

• 2.4 times as likely to experience ongoing anxiety

• 2.5 times as likely to experience panic reactions

• 3.6 times as likely to be depressed

• 3.6 times as likely to qualify as promiscuous

• 6.6 times as likely to engage in early-life sexual intercourse

• 7.2 times as likely to become alcoholic

• 11.1 times as likely to become intravenous drug user

The amount of research producing similar results is almost overwhelming. There's an undeniable link between early-life trauma and numerous adult-life physical and psychological disorders. Test every client for early-life trauma, and even the individuals who initially insist that they had an idyllic childhood tend to score 3 or higher. We treat sex and intimacy disorders, which tend to be shame and trauma driven. Two-thirds of all people score at least one point on the ACES screening.

In a nutshell, research reveals that childhood trauma is common among all races and social strata. Very often it is unidentified, unacknowledged, and unaddressed. And it contributes to all sorts of adult-life physical, emotional, and relational problems. Additionally, there is a lack of explanation about

Information from U.S. Center of Disease Control

Appendix 2

The basic ACES Screening test is a mere ten questions, and it’s limited to five personal and five familial categories. The instrument does not examine bullying, racism, financial struggles, severe illness or accident, and a thousand other possible forms of trauma. Additional explanation about what may qualify in a particular category. For instance, an overly enmeshed, covertly sexualized relationship with a parent is, from a psychological standpoint, a form of both sexual abuse and emotional abuse /neglect (adversely affecting the child’s emotional and relational development). But most people, especially those new to the process of healing.

Information from U.S. Center of Disease Control

Take the initiative do not let the initiative take you. Maladaptive stress correlates: The frontal cortex becomes inhibited (lack of impulse control), the amygdala is unstable (emotional dysregulation), and the nucleus accumbens neurotransmitter imbalance (pleasure reward center) leads to risky behavior.

Perrin suggests: The ACE measure may be used as a form of pre PTSD, because these brain specifics are prominent in PTSD and PTSD is difficult to treat. Do not let maladaptive stress become the predecessor of who you are, how you function, how you carry your heart. Another scenario is alcohol the emotion and thinking brain centers are affected the same for those that drink. If your all stressed may drive you to drink- overlap- comorbid condition. I go the extra mile because I care It hurts me when others hurt, even if they are hurting me, is a result of their hurting.

APPENDIX B

The Spirit Level

Why greater equality makes societies stronger How many times richer are richest 20%

Richard Wilkinson and Kate Pickett to the poorest 20%

(Richard Wilkinson 2010) U.S. 8.5 times

Inequality is obvious but these studies Japan 3.4 times

Bring points about social gradience, and everything

Is lower at the bottom. Violence. Education homicides

So many problems at the bottom and a lot of this is social

Life expectancy, depression, self- enhancement rate higher

Related to social status increase inequality it gets worse between studies in all countries.

Sensitivity to indifference, mental illness

social processes behind data some seen supreme important/ some not judged by status

Psychosocial Risk Factors insecurities anxiety from not being valued like that from a difficult childhood

1. stress in early life

2. low social status

3. weak social connections

affects the health of population as a whole

Status Class more important- more powerful-l in countries with higher inequality

Test for cortisol level under social evaluative threat Status competition Can either have people withdrawal or become more powered by self-image

Goal make status difference lower/ lower the stakes

Citations

Burke, D. N. (2018, November 25). The Science of ACEs is Fundamentally Hopeful. ACE-Nation Aware Conference. Scotland: You Tube.

Campos-Vasquez, R. D.-C. (2019, FEB). 56(1), 321-343. doi:10.10071s13524018-0734-z

Collins, P. H. (1995). toward a New Vision: Race, Class, and Gender as Categories of Analysis and Connection. Boston: McGraw-Hill.

Johnson, D. C. (2014). Divided The Perils of our growing inequality. New York : The New Press.

Mendoza-Denton, N. (2008). HomeGirls. Malden: Blackwell.

Philippe Bourgois, J. S. (2009). Righteoud Dopefiend. United states: University of California Press.

Richard Wilkinson, K. P. (2010). The Spirit Level. New York: Bloomsbury Press.

Robert N. Bellah, R. M. (1985). Habits of the Heart. London: University of California Press.

Just because there is a lot of diversity in race, class, and gender in California does not mean that social suffering does not exist, and that inequality is not rampant. Deemed as social categories race, class, and gender are the predominate ways people make assumptions of others by how they behave and think. Connecting with one another is often based on status, therefore it is not always easy because individual identity is often assumed through the lens of a dominant and subordinate race, class, and gender binary system. Consequently, the Latin gang girls experienced structural violence in the story home girls, and their identity was inflicted, because of the structural barriers and social inequalities that confronted them. Studies performed by Nadine Burke Harris a renowned Adverse Childhood Experience (ACE) expert has found that the level of adversity a child experiences, while they are in their developmental years is a factor that can determine a number of learning and behavioral difficulties, and if not addressed can lead to long term health consequences. Two different research paradigms- income inequality, ACEs show that people share the same type of behavioral issues, and that these issues are only prevalent in more unequal countries. These issues are the kind that lead to single mothers, broken homes, and commonly cause trauma at the transgenerational level. Ace studies find that vulnerable individuals raised in unequal high stress environments are susceptible to negative health consequences from an exasperated maladaptive stress response. This paper looks through this lens at variables of structural violence and empowerment/identity at the intersection of race, class, gender in relation to human development and the stories “Righteous Dopefiends”, and “The Home Girls”. One short coming in using social constructs to understand race, class, and gender

PEREZ 2 indifferences is that people often fail to consider what the experiences and conditions were that a person had to contend with in their developmental years. Identifying and being socialized is an important part of the development process. Parents at a higher socioeconomic status (SES) levels foster negotiation and self- sufficiency skills in their children, which children in poorer households have less supervision, lower levels of autonomy and fewer school related activities as related to skin color and social mobility (Campos-Vasquez, 2019). Social suffering and being raised in a negative environment are factors that may lead to of adverse childhood experiences (ACE) and toxic stress. The “Righteous Dopefiends” and the “Homegirl’s” story may serve as an example of how environment, nurture and being socialized during childhood may affect them in their later life. The majority of the Righteous Dopefiends had the worst childhood experience. Carters Father beat his mom, Tina’s mom whipped her and told her that she did not want her, and Sonny experienced the streets before he knew what they were. Sonny had a stable childhood but being low status class societal conditions exposed him to drugs and crime. All ethnicities are exposed to ACE, and the higher the ACE score the more apt an individual is for mental health issues The Edgewater homeless became homeless drug addicts that had bad experiences in their childhood in which they may have never recovered. The Latina gang girls at San Juan High School (SJHS) had experienced structural violence, but they were able to stay strong and relinquish their identity through their friendship. The Latin gang girls had problems to deal with at school being an ethnic minority in a socially dominant white school, and they used a tough gang girl image to balance out the negative effects of symbolic violence.

PEREZ 3 . Pierre Bourdieus concept of symbolic violence links immediate practices and feelings to social domination (class notes). An example of symbolic violence is how the Latin gang girls are interpreted as the subordinate class at SJHS, so their reaction may be to blame themselves for this, therefore they act Macha. Being discriminated based on differentiation of class is stressful. Acting “Macha” is one way for them to identify as tough and confront the social domination that haunts them every day. The level in which they interpret this social threat is high, which may give reasoning to why they adjust their identity to portray a characteristic that, in contrast to gender binary norm of female. Identifying and fitting in to your general surroundings can be tough in the face of inequality.” Human beings and their societies are deeply interrelated, and the actions we take have enormous ramifications for the lives of others” (Robert N. Bella 1985, 284). How one interprets social class inequalities may affect their self-image/identity.” A home girl T Rex said, “being a gang girl is not a way to act but is a way to get respect and stand up for yourself” (Mendoza-Denton 2008, 169). The Latin gang girls social pain was high and they faced these inequalities the best they knew how. The adversity (i.e. structural violence) that the Edgewater homeless experienced in their societies and childhood experiences catapulted them into a tunnel of endless hope and pain in which they were unable to recover. Development can be derailed due to toxic stress, which makes it important to be aware of difficulties that exacerbate pain, crises, and emotion, especially when someone is experiencing adversity when they are young. METHOD . I used a correlational study approach comparing two studies and found a high

PEREZ 4 prevalence of connectivity to social issue that the lower sector of the social hierarchy experience. Upon researching these studies I hypothesized: If the behavioral issue/social problems (alcohol and drug use, Teenage pregnancy, teen paternity) are a symptom of toxic stress that contribute to the problem, then the environmental conditions (i.e. social, developmental) that create the toxic stress need to be addressed to begin resolving the problem. I understand correlation does not imply causation. This hypothesis is like a proposal for action, because if we can understand it then it gives us the tool to begin fixing it.

The transcription for Dr. Nadine Burke Harris was from a conference that she did in Scotland (first ACE aware nation) called ACE-Aware Nation Conference- The science of ACE’s is fundamentally hopeful (Burke, 2018).

The original study for Adverse Childhood Experience’s was done by Kaiser Permanente and the Center for disease Control in 1995 and had 17,500 participants. Appendix A share the specifics ACE information. The Income Inequality studies are don by Richard Wilkinson a leading research specialist in this field. Original Ace study N= 17,337 Emotional abuse 10.6% Physical abuse 28.3% Sexual abuse 20.7% mother abused 12.7% Household sub. abuse 26.9% mental abuse 19.4% Parent sep. divorce 23.3% incarcerate fam mem. 4.7% Emotional neglect 14.8% Physical neglect 9.9% Figure 1 statistics from the original ACE. Info from U.S. Center of Disease Control

PEREZ 5

Outcomes of ACEs affect- alcoholism and alcohol abuse, COPD, depression, health-related quality of life, illicit drug abuse, heart disease, liver disease, poor work performances, financial stress, risk for intimate partner abuse, multiple sexual partner violence, STD’s, smoking, suicide attempts, unintended pregnancies, early initiation of smoking, early initiation of sexual activity, adolescent pregnancy, risk for sexual violence, poor academic achievement. I also used info from Richard Wilkinson and Kate Pickett book The Spirit Level (Richard Wilkinson, 2010). Psychosocial Risk Factors stress in early life, low social status, and weak social connections. The factors connecting the ACE & income inequality are the psychosocial issues. The income Inequality study tells us about inequality affects social status The ACE study Biological findings indicating stress becoming maladaptive is the underlying mechanism that lets us know what we can do. Inequality studies show to have equality have to lower the overall incidence of stress problems circular behavioral from adults. Must lower these statistics in Fig. 1 this begins practicing ACE awareness 7 the goal stop collective trauma today by working on these and all issues that cause stress and transgenerational trauma for the poor. –INTERVIEW-- Leading thinker of adverse childhood experiences can this count as ACE literature rev.? We turn over the conversation to Dr. Nadine Burke Harris to help us better understand the devasting effects of Adverse Childhood Experiences. -Literature review of ACE- Transcription: . Prompter: What are adverse childhood experiences? . Dr. Nadine Harris Burke: A tool used to test people for the adversity the have experienced. Adversity tests: abuse- physical, emotional, sexual.

PEREZ 6

Neglect- physical, emotional. Household-mental illness, mother treated violently Prompter: Who is affected by Ace scores? Dr. Nadine Harris Burke every ethnic group is affected- black, white, Hispanic, Asian, Pacific-Islander results are similar across all the ethnicities.

Prompter: Are there any societies that show a higher prevalence of symptomology?

Dr. Nadine Harris Burke: Results of the studies are similar between ethnicities, but people from poor lower status suffer at a higher rate due to the environmental factors (adversity) that they contend with.

Prompter: why should we be concerned?

Dr. Nadine Harris Burke: There are a lot of reasons we should be concerned. High ACE scores result in learning and disabilities in children is often toxic stress, but often misdiagnosed with ADD/HD and wrongly medicated. The study indicates that behavior and learning difficulty are due to factorial adverse childhood experiences.

Prompter: What is the clinical outcome of too much toxic stress?

Dr. Nadine Harris Burke: The outcome is not good if these disorders are not caught early. public health problems from this disorder connects to development to adulthood issues of mental health conditions due to a maladaptive stress response- means the HPA stress response system is maladaptive from being in the stressed continually- inhibited frontal cortex- lower level executive functioning increased level of impulsivity, amygdala (emotional center of brain is overactive), Nucleus accumbens (pleasure reward center) imbalance. There real neurological concern being the altered neurological function. A child with too much stress has behavioral and learning disorders these biological irregularities have already set in.

Prompter: Since all ethnicities have similar results of ACE scores are there any

other groups in society that experience adversity any more than any others?

PEREZ 7

Dr. Nadine Harris Burke: The ACE study has 5 familial and 5 personal categories totaling ten questions regarding adversity. There are many other factors to condition an adversity effect (i.e. bullying, racism, financial struggles). See appendix A.

Prompter: This suggests an environment condition affects lower class status individuals, because they are affected at a higher rate due factors experience in their daily living.

Dr. Nadine Harris Burke: My medical clinic is in the worse neighborhood in San Francisco. Statistic presented in this population; 2/3 of my patients have 1 or more ACE score, 1 in 8 of my patients have four or more ace scores, and these kids are 32% more likely to experience behavioral and learning disabilities. Kids with 0 ACE scores from the same population are only 3% likely to have behavior or learning disabilities.

Prompter: What social problems are correlated to children with four or more ACE scores?

Dr. Nadine Harris Burke: The level of adversity varies, but these studies clearly indicate behavior problems lead to alcohol and drug use teenage pregnancy, early inception, teen paternity are related to presentation of four or more ACE scores based on outcomes of adverse childhood experiences.

Prompter: it is alarming that too much toxic stress can cause behavioral issues at this complexity, and if not corrected can determine an outcome such as negative health consequences.

Dr. Nadine Harris Burke: Neurological as well- Multi-systemic alterations- long term changes to fight or flight response, overactive fear response, changes in brain structure and function can interfere with learning, changes to brain biology to increase risk of addiction/high risk behavior.

Prompter: Thank you (Burke 2018)

Literature Review: Income Inequality (inequality) correlated to Adverse Childhood Experiences: Harris deems that behavior and learning issues are only the symptoms, that the kids are not the

PEREZ 8 problem. That the problem is toxic stress, because the many variables of adversity that they are confronted with in their daily lives. This sheds light, that social problems caused by stress continue to compound inequality for those at the bottom, and these problems contribute to the underlying mechanism for their not getting ahead generation after generation. It raises awareness that social constructs that stigmatize the lowest social hierarchy are real, and what are implicated as behavioral failures are not necessarily failures, but symptoms of exacerbated stress. If the behavioral issue/social problems (alcohol and drug use, teenage pregnancy, teen paternity) are a symptom of toxic stress that contribute to the problem, then the environmental conditions (i.e. structural violence) that create the toxic stress need to be addressed to begin resolving the problem. Since this is a multi-faceted problem and we are aware that toxic stress is the underlying mechanism then it is necessary to remedy as many factors as possible that add to toxic stress. Remedy the behavior before difficulties of maladaptive stress become a permanent neurological impairment. . “Further investigating issues of inequality, research performed by” (Wilkinson, 2010) show observable correlations to the same behavior problems/social issues that Dr. Harris Burkes ACE research have shown. The Prevalence of high incidence of behavioral/social issues problems between these two studies are (i.e. alcohol and drug use, teenage pregnancy, teen paternity) revealing. Behavioral problems/social issues are related to the of poor, however these behavioral problems/social issues are not prevalent to that of the more equal societies. The income inequality studies show the same behavioral issues as people with high ACE scores are only prevalent in more unequal countries, and that these issues are the kind that lead single

PEREZ 9 mothers and broken homes these issues continually cause trauma at the transgenerational level. The outcome of the ACE studies exemplify that the scores between all the multi- ethnicity- black, white, Hispanic, Asian, Pacific-Islander scores were similar. This is intriguing because the prevalence of behavioral problems/social issues in inequality leans more to those lower on the social hierarchal ladder (black, Hispanic). This raises awareness that environmental conditions in lower economic societies play a big role in the higher accumulation of behavioral problems/social issues. The ACE study is reliable there is an additional screening for other possible forms of trauma (appendix A-2). This is one conflicting outcomes of ACEs study that equality studies helps to unfold. The equality study correlates the same behavioral problems/social suffering as ACEs and reports that these issues are only prevalent in nations with high inequality. Analysis It is apparent that a systemic inequality exists and contribute to behavioral problems/social issues that these folks in the lower societal position. This indicates broad societal failings that neglect correcting environment/social conditions that lead to toxic stress and collective trauma at the transgenerational level. One way to dehumanize an individual or a group is to deny the reality of their experiences (Collins 1995, 4o). The majority fail to recognize the social suffering of black people and do not see class differences for what they are. It is symbolic violence to see personal character flaws when inequality and ACE studies both show that broad societal failings, and social inequality are underlying factors of their stress condition. Poor people often blame themselves and accept the stereotype that they have moral

PEREZ 10 flaws. “But poverty reflects broad societal failings more than individual shortcomings” (Johnson, 2014, 103). What is needed is to find equilibrium in the complexities of indifference towards unity with those towards the bottom of the hierarchal social order of indifference. Are tensions (biological stress response) a two-sided coin of empowerment/identity that cause distress that may instigate racial disequilibrium? With the relation of these issues to high ACE scores and inequality, makes it hard not to ponder the pecking order in society and how subjectivities of the power and privileged are handed down and impressed among the lower order. Many of these variables are hard to uncover, but one commonality, surely related to mankind, society, and how race/class affects us is human emotion, identity, and how one identifies with those around him. ”Currently, we are all enmeshed in a complex web of problematic relationships that grant our mirror images full human subjectivity, while stereotyping and objectifying those most different than ourselves” (Collins 1995, p. 35). If America did not have such a high level of indifference between the ordinate vs subordinate it may not have such prevalence of empowerment identity issues. How race/class inequalities are assumed and presupposed onto others can place a socially validating or invalidating effect on their empowerment/ identity. These effects are also transposed at the neurological level, so being socially validated, or not affects human beings at the biochemical level of the (positive or negative) social reinforcement system. The coincidence is that thinking and balancing emotions are the same brain functions that get altered inhibited (thinking) or exasperated (emotion) when the stress response is activated. One’s empowerment /identity will be reinforced based on their likes and dislikes

PEREZ 11 (habitus), in accordance to the persons views and opinions. The views people hold of the ordinate and subordinate class may be opinions, but in reality these opinions at the conscious level are a derivative of belief, and how it is reinforced (feel bad or good) at the biological level depends on if you feel your habitus if reinforced or not. Balance is an emotion/thinking process. Race, class, gender relations can be challenging, therefore it may help to be aware of why indifference and status can make some people sensitive to these issues. . The poor seem to have the triple whammy against them. Being at the bottom of the social hierarchy is probably a small worry for them over the factors in life for example, structural violence and environmentally unsafe conditions. Analysis of the income inequality studies (appendix B) was the recognition of complexity of social problems that exist and how important early intervention is to prevent maladaptive neurologic function that leads to bad decisions. Correlations in these studies revealed (from equality statistics) that people often become a victim of their environment. From ACE studies I learned that people who suffer inequality act out behaviorally and that implication from these behaviors lead to long term consequences that affect the next generation. For example, teen pregnancy that leads to a single mom then a neglected child (lack of resources) and then the circular problem repeats itself. These folks continue to suffer structural violence in the institutionalized criminalization (i.e. punitive sentencing, high incarceration rates) for this sector of society which also contributes to their lack of family structure. If the behavioral implications are symptoms then broad societal issues may exacerbate the problem for example, professional agencies that do not see symptoms, but condemn a behavior. Structural violence if these people have disparate access to resources,

PEREZ 12 and it is important incur all circumstances of development, rather than neglect to offer rehabilitation where it is needed (multi-dimensional approach). The point in the long run if behavior is a symptom the issue needs to be uncovered, because healing (i.e., shame, toxic stress) any foundational problem of the issue is control, because the behavior will be resolved and not exacerbated. . “This research shows that societies with high income inequalities between the rich and the poor have many issues including issues with trust, mental illness (including alcoholism and drug addiction), homicides and other social problems” (Richard Wilkinson, 2010, p. 19). Thinking along the lines of prejudgment is the cause of many of the social problems that are already prevalent in society today. It is also a step of one’s habitus neglecting the capacity of the brain for rational logical thought which promotes healthy brain function. The ACE study finds profound evidence that maladaptive brain circuitry could result from toxic stress. It may help explain evil acts, because anytime an atrocious event or hate evolves it is most definitive to be invigored through one’s habitus and emotion. Harris (2018) specifies actions of the brain that usually give us control become a loss of control. The frontal cortex becomes inhibited (lack of impulse control), the amygdala is unstable (emotional dysregulation), and the nucleus accumbens neurotransmitter imbalance (pleasure reward center) leads to risky behavior. Ace scores and the criteria that tests for extra environmental stressors (appendix A) are a very important tool to use to verify if you are a candidate for toxic stress, or if behavior and learning disabilities are stress related. Dr. Harris Burke informs us that once symptoms of toxic stress appear if not corrected biological impairment happens quickly and is difficult to correct. . PEREZ 13 . The biological mechanism for stress response helps in an emergency, but when this system become overextended to the point of being maladaptive it wreaks havoc and disrupts the balance of daily living. What is causing the stress is the problem that needs to be fixed. The combination of the ACE and Equality studies indicate the relevance of these factors and that multi- ethnical in nature and that people at the bottom of the social hierarchy of systemic inequality are most susceptible. “Many join gangs to escape their abusive family but pay a hardship (social injury hypothesis) of sexual stigmatized” (Mendoza-Denton 2008, 162). The Edgewater homeless had terrible childhood experiences which delayed growth and was a factor that prevented them from developing to live a healthy functional life. They became homeless drug addicts with the main satisfaction in life coming from heroin use. Everyone complained hated seeing these folks they were the rock bottom eye sore in society, nonetheless a product of society. Sonny was the only one mentioned in the text that came from a stable family, yet experienced negative environmental conditions in his society he suggested later in a failed after school program that he wish he could have continued with. This is an example of how the environment vs. healthy nurturing plays a negative role in one’s development, and we will here how the structural violence of institution setting failed him. Policy and Initiative suggestions: . Societal problems will never mend till we mend our people. Understanding issues that cause stress and that toxic stress can be indicated in people with high ACE scores is a tool that can be used for enhancement and quality of life. Sonny an Edgewater homeless had a stable

PEREZ 14 family but interactions of bad environment of being on the street when younger, and he was drawn into a local peer group. He bragged later in life of an after school program that he enjoyed because he built things, but funds for this program and social service’s were cut to support” Nixon’s war on drugs” (Philippe Bourgois, 2009, p. 162). Nixon’s authoritarian rule was extreme and destructive. The scenario Sonny explained is all too common in symbolic and structured violence overlooking benefits that help build the lower status people. That is not on the agenda, this would reflect flexibility of empowerment and the priority of one’s habitus. To be more open we must put generalizing and confirmation bias aside to see root cause scenarios, and not be fooled by behaviors that are symptoms of another problem. A leader that thinks out of the box and seeks a wider range of possibilities may have a better outcome. The nature of this multi- faceted approach is more flexible, and more resilient to stress. The mindset that see’s the importance of early intervention is more apt to take ACEs and inequality more seriously. Every situation is unique and individualized. For example, if someone has high ace scores then finding and addressing variables that lead to stressors in their specific environment is necessary. Intervention for people with high ACEs is often recognizable through behavior and learning difficulties. Therefore, social service agencies should practice ACE awareness. They can do this by sharing ACE resources and protocols for folks with perceived behavior problems. A derivative of early intervention is awareness, and to have measures in place to test those suspect of high ACE scores. Therefore, the initiative I suggest is that California should become the first ACE aware state. The actions necessary are as follows: Due to the extremity of societal conditions, the detriments of toxic stress, and the ability for

PEREZ 15 ACE testing to recognize and offer antidote to these conditions I suggest the following policy. That ACE testing should become a part of every medical plan. Implement regular screening and testing. Schools should also be aware of any person that is exhibiting behavior, and/or learning disabilities, and have measures in place to test and treat the foundational problems that are creating stress for the individual. Social services should be provided free of charge for all ACE situations that arise for youth. . I am passionate in hope that ACE and equality studies can remedy the transgenerational downfalls for those that struggle, and see America become a more equal nation. Our habitus forms greatly as we develop in life, but that does not mean it stops here. A disciplined thinker becomes familiarized with habitus that leads to social injustices and is always reasoning, rationalizing, and learning to form habit, character, and destiny not just for themselves but justice for others as well.

APPENDIX A

What Is the ACES Screening?

The ACES test that we use in California screens for 10 forms of childhood trauma—five personal, five familial.

Personal Traumas

• Addiction

• Domestic violence

• Incarcerated family member

• Mental illness

Divorce or abandonment

• Physical abuse

• Verbal abuse

• Sexual abuse

• Physical neglect

• Emotional neglect

Familial traumas:

• Addiction

• Domestic violence

• Incarcerated family member

• Mental illness

• Divorce or abandonment

The ACES test is scored 1 through 10, with each type of trauma experienced counting as one point. An individual with alcoholic father and an early-life history of verbal abuse and emotional neglect would score three on the ACES screening.

APPENDIX A CONTD.

Life is too darn short to not go all out and try to make the Best of it C’MON we got this

Nobody wins unless we all win

Research is very consistent with these results. For example, one wide-ranging found that individuals with an ACES score of four or higher are:

• 1.8 times as likely to smoke

• 1.9 times as likely to become obese

• 2.4 times as likely to experience ongoing anxiety

• 2.5 times as likely to experience panic reactions

• 3.6 times as likely to be depressed

• 3.6 times as likely to qualify as promiscuous

• 6.6 times as likely to engage in early-life sexual intercourse

• 7.2 times as likely to become alcoholic

• 11.1 times as likely to become intravenous drug user

The amount of research producing similar results is almost overwhelming. There's an undeniable link between early-life trauma and numerous adult-life physical and psychological disorders. Test every client for early-life trauma, and even the individuals who initially insist that they had an idyllic childhood tend to score 3 or higher. We treat sex and intimacy disorders, which tend to be shame and trauma driven. Two-thirds of all people score at least one point on the ACES screening.

In a nutshell, research reveals that childhood trauma is common among all races and social strata. Very often it is unidentified, unacknowledged, and unaddressed. And it contributes to all sorts of adult-life physical, emotional, and relational problems. Additionally, there is a lack of explanation about

Information from U.S. Center of Disease Control

Appendix 2

The basic ACES Screening test is a mere ten questions, and it’s limited to five personal and five familial categories. The instrument does not examine bullying, racism, financial struggles, severe illness or accident, and a thousand other possible forms of trauma. Additional explanation about what may qualify in a particular category. For instance, an overly enmeshed, covertly sexualized relationship with a parent is, from a psychological standpoint, a form of both sexual abuse and emotional abuse /neglect (adversely affecting the child’s emotional and relational development). But most people, especially those new to the process of healing.

Information from U.S. Center of Disease Control

Take the initiative do not let the initiative take you. Maladaptive stress correlates: The frontal cortex becomes inhibited (lack of impulse control), the amygdala is unstable (emotional dysregulation), and the nucleus accumbens neurotransmitter imbalance (pleasure reward center) leads to risky behavior.

Perrin suggests: The ACE measure may be used as a form of pre PTSD, because these brain specifics are prominent in PTSD and PTSD is difficult to treat. Do not let maladaptive stress become the predecessor of who you are, how you function, how you carry your heart. Another scenario is alcohol the emotion and thinking brain centers are affected the same for those that drink. If your all stressed may drive you to drink- overlap- comorbid condition. I go the extra mile because I care It hurts me when others hurt, even if they are hurting me, is a result of their hurting.

APPENDIX B

The Spirit Level

Why greater equality makes societies stronger How many times richer are richest 20%

Richard Wilkinson and Kate Pickett to the poorest 20%

(Richard Wilkinson 2010) U.S. 8.5 times

Inequality is obvious but these studies Japan 3.4 times

Bring points about social gradience, and everything

Is lower at the bottom. Violence. Education homicides

So many problems at the bottom and a lot of this is social

Life expectancy, depression, self- enhancement rate higher

Related to social status increase inequality it gets worse between studies in all countries.

Sensitivity to indifference, mental illness

social processes behind data some seen supreme important/ some not judged by status

Psychosocial Risk Factors insecurities anxiety from not being valued like that from a difficult childhood

1. stress in early life

2. low social status

3. weak social connections

affects the health of population as a whole

Status Class more important- more powerful-l in countries with higher inequality

Test for cortisol level under social evaluative threat Status competition Can either have people withdrawal or become more powered by self-image

Goal make status difference lower/ lower the stakes

Citations

Burke, D. N. (2018, November 25). The Science of ACEs is Fundamentally Hopeful. ACE-Nation Aware Conference. Scotland: You Tube.

Campos-Vasquez, R. D.-C. (2019, FEB). 56(1), 321-343. doi:10.10071s13524018-0734-z

Collins, P. H. (1995). toward a New Vision: Race, Class, and Gender as Categories of Analysis and Connection. Boston: McGraw-Hill.

Johnson, D. C. (2014). Divided The Perils of our growing inequality. New York : The New Press.

Mendoza-Denton, N. (2008). HomeGirls. Malden: Blackwell.

Philippe Bourgois, J. S. (2009). Righteoud Dopefiend. United states: University of California Press.

Richard Wilkinson, K. P. (2010). The Spirit Level. New York: Bloomsbury Press.

Robert N. Bellah, R. M. (1985). Habits of the Heart. London: University of California Press.

.

.