Viral Violence and the Challenge for Public Safety

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As the screens we carry narrow our proximity to random and targeted acts of violence, many parents and families are rightfully questioning the impact viral violence has on shared perceptions of public safety and child health.

In pediatrics, we have long considered the link between media, violence and health.

We know kids who watch fake violence in movies or play violent characters in video games show signs of increased aggression. But what happens when the violence kids watch is real? Or when the cameraperson is only a teenager?

Today, youth can easily capture and consume real violence, in real-time, as a part of their daily routines – from snapping school violence, live streaming police violence, recording sexual violence, or sharing images of political violence. This is the new normal* and it’s more complex than the simple relationship between simulated exposures and aggression.

A child watching real violence from their cell phone now understands something tangible about the world; and a kid who records or shares violent imagery online can contribute to others understanding of the world. That elevation of the voices and experiences of youth can be extremely valuable. Indeed, in terms of activist’s movements like Black Lives Matter, the perspective of youth, magnified by social media, has become a national catalyst for police reform, criminal justice reform, and racial equity.

Yet, perpetual exposure to viral violence takes its toll – often manifest in feelings of victimization, grief, fear, intimidation, anger and sadness. And kids and teenagers may be most vulnerable to this kind of trauma because they are still developing the emotional and intellectual maturity to process troubling events. What is more, they rely on trusted adult figures to provide safe spaces in their life.

As we face these harrowing challenges, consider two thoughts:

1. While it’s okay to be protective, thoughtful and proactive regarding how youth experience and contribute to violent images online, we, as parents, caregivers, or providers, cannot simply turn a blind eye. While distressing, some images of violence advance our collective understanding, compassion, and empathy for the suffering that exists outside the walls of our private communities or our segregated social groups, and the privileges those spaces confer. In this way, confronting the visual of violence with a particular effort to center the interpretation of the events around the marginalized populations disproportionately affected, is the first step towards collective healing. And that healing begins with rigorous and vigilant public exploration of the ways systemic racism, sexism, Islamophobia, homophobia, xenophobia and intolerance threaten public safety.

2. As we live-stream our lives, we open windows to the neighborhoods we live in, the spaces where our kids learn and play, and the ways we perceive and are perceived in the world. When we don’t like what we see on the other side of that window, it can be easy to hide discomfort or insecurity with blame or shame or to create narratives that distort the humanity we witness. But each time one of us resists the opportunity to understand the burdens or experiences of another, we all move further from the co-existence necessary to bring peace.

*This is a piece I wrote with my friend and colleague, Dr. Wendy Sue Swanson, that was published in the July 2016 Pediatrics. It is available for free online for the first week of publication.

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What an Oreo can Ad to Medicine

OreoHow do you prepare for something that doesn’t exist?

In medicine, what tools will be required to build a better future for providers, patients, and the many advocates who work to make health realized?

Like our predecessors before us, embracing an unknown future will likely require solutions that are part rigorous methodology and part instinctual art. I am confident that the rigorous methodology that makes science unique among fields of scholarship will continue to advance discovery in health and disease management. But how can modern-day physicians and health advocates use the art of our practice to increase health literacy, connect the dots between health and society, and optimize our relationships with complementary fields?

When I saw the Oreo Super Bowl ad, I knew. This is what medicine should be doing. Not pushing sugar sweetened products, but utilizing moments to capture national attention around a singular idea – health.

For those of us interested in the exciting opportunities new technology offers the field of medicine, Oreo taught us that capturing national attention may be as simple as fostering thoughtful application of new media; media that for all said purposes, is free (although the thoughtful application part definitely requires a significant investment…more on that in future posts).

It is clear that consumers are now making decisions in the context of an online network of peers where they collectively share cultural experiences and discuss trending topics in news and popular media. This is an incredible opportunity to key into consumers who are looking for health information, information that data suggests some are using to make health decisions. Interacting with patients on their timetable, moderated by their thoughts and comments, and based on their personal priorities, allows medicine to have a greater impact beyond the confines of our offices and medical centers. And I’m not just talking about e-visits (although this is an interesting and potentially great idea), I’m talking about engaging a national audience in a conversation about health, identifying partners in this work, and aligning all of our interests to reach a common goal – health.

Part of preparation for any unknown outcome is recognizing opportunities to take steps in the right direction. New technology, like that promoted by incubators like Rock Health and thought leaders like Wendy Sue Swanson, MD and Bryan Vartabedian, MD, will definitely define the future of our field; a future that I hope is rooted in simplicity, transparency, and good old customer service.

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Innovation in Medicine

I am becoming more and more convinced that the greatest opportunity to impact patient behavior and lifestyle choices (the single greatest contributor to one’s health) begin in the community and the idea that a clinic is the catalyst for change or hub of health promotion is obsolete.

What if instead of placing more value (square feet) in “innovative” buildings where doctors exist, we placed value (money) in innovative solutions centered in our communities, where the circumstances that beget health disparities exist? What if some* health issues are really social justices issues – shared problems that are contingent upon resources, access, education, and literacy? If that is true, as I believe it is, then doctors don’t have all the answers and clinics aren’t the only cure.

So the question becomes:

How can our institutions of health bend toward the need and stay relevant in the spaces where people live, work, and play?

I have one idea.

Social media – or the technology and web-based tools used to connect people, resources, and ideas – offers an incredible opportunity for physicians to meet patients where they are, and the data suggests, patients are online. Advancing community engagement initiatives in medicine demands new solutions to complex and challenging problems. Future success relies on how well medicine, as a field, takes advantage of the technology to broadly disseminate credible health information in a space where patients set the agenda. Moreover, using social media to create partnerships between key stakeholders in community health, including community advocates and local and state government, can revolutionize our current models of care and add civic engagement to a physician’s repertoire of treatment modalities.

Admittedly, social media is not the entire solution. But, embracing new technologies to eliminate traditional barriers that prevent the medical system from responding to healthcare needs in holistic and systemic ways, is an important start. Future work must address the potential health disparities that may be created when access to health information is contingent upon access to the internet. However, much is being done to advance mobile health solutions to ensure that everyone benefits from the sharing of information and pooling of resources likely to mark the new age of social media in medicine.

Exploring the uses of social media in medicine is a growing interest of mine and I am fortunate to be connected to a few leaders in the field who are really blazing the trail including Wendy Sue Swanson, MD, Bryan Vartabedian, MD, Ricky Choi, MD, and Heidi Roman, MD. Click on their name and follow them on twitter!

What do you think about social media in medicine?

Footnote: * Some medical problems clearly require medical care that can best be provided in a hospital and/or clinic setting and patients with such ailments rightfully deserve the benefits new technology and innovative medical strategies may bring to bear on their treatment course. This statement is only meant to highlight the growing number of patients who rely on our healthcare system because of problems that currently lie outside the purview of “physician” responsibilities. This illustrates the need for partnerships between physicians, patients, community advocates, and local government to collectively address the needs in our communities that beget major health problems and significant health disparities.