Science
Opinion: Fentanyl could fuel another cycle of loss in L.A.'s Black communities. It doesn't have to
The death of a parent is typically a gutting and disorienting experience for adults. For a child, it’s even worse, stoking feelings of frustration and abandonment and sometimes self-destructive behaviors such as drug use that can continue well into adulthood. This has particularly serious implications when the child is Black and therefore more likely to end up in the child welfare system.
A recent report by federal researchers provides the fullest picture yet of the sprawling impact of overdose deaths on Black children in Los Angeles and other cities — and what we can do about it.
From 2011 to 2021, the report found, more than 321,000 American children lost a parent to a drug overdose. Black children experienced the highest increases in the rate of such losses during those years, compounding a long-standing public health crisis across Black America. Like much of the United States, Los Angeles has seen drug overdoses soar in recent years, with disproportionate losses among the city’s Black adults.
Black people are significantly more likely to experience drug-related deaths due to limited access to treatment and resources such as naloxone, which can reverse overdoses. When they’re parents, the toll on their children is both rapid and deep. Parental drug use is highly associated with use among children.
Although Black children make up just 7.4% of the Los Angeles County population, they represented 24% of those who entered the child welfare system in one recent year. One study found that about 47% of Black children in California were the subject of a maltreatment investigation before the age of 18, with substance use accounting for 41% of the state’s child maltreatment cases.
The disproportionate number of Black children in Los Angeles’ child welfare system has been scrutinized since the late 1980s, the height of Los Angeles’ heroin and crack epidemics. The drugs, then largely addressed as a criminal issue through heavy-handed policing and prosecution, consigned a generation of young and middle-aged Black Angelenos, both users and dealers, to premature death and incarceration. Many of their children wound up in the city’s fragmented child welfare system and, all too often, on a similar path toward addiction and entanglement with the legal system.
When a child’s parent dies, other family members — the child’s other parent, grandparents, aunts or uncles — are the first resort to assume responsibility for their care. But Black children, especially those from low-income communities, often end up in the child welfare system instead.
Why? The child’s surviving family members may lack the resources to fill the breach. But racial biases also predispose child welfare workers to remove Black children from their families and impede reunification efforts.
Research has consistently shown that child welfare workers more readily define Black parents’ behavior as abusive or neglectful even when it’s comparable to the conduct of parents of other races. Child welfare workers are also more likely to regard Black families as less loving of their children and less redeemable.
Children who enter the child welfare system due to parental death already spend twice as much time in the system. Black children tend to remain in the system even longer because of bias.
The twin depredations of Los Angeles’ opioid epidemic and its child welfare system are daunting but not beyond repair. The first necessity is to revamp the city’s racially biased child removal process. Los Angeles officials have been piloting a “blind removal” approach in which investigations are followed by a decision-making process that excludes demographic details such as the child’s race. This is a step in the right direction.
However, a UCLA study of the pilot program revealed that racial disproportionality persists, demonstrating how deep-seated child welfare biases are. For blind removal to be effective in eliminating racial disparities, it must be supplemented by greater transparency, expanded civilian review boards and training in implicit bias.
Second, we need a better understanding of the consequences of placing Black children in the child welfare system. In general, Black children in the system are highly stigmatized, especially when they come from families with histories of drug abuse. That contributes to making them less likely to be adopted. The trauma of losing a parent also means they’re more likely to experience depression and anxiety.
These experiences frequently devolve into social isolation, poor academic outcomes, limited employment prospects and incarceration. Officials must work to identify these patterns early and provide resources such as mental health care to disrupt this harmful cascade.
Lastly, policymakers must continue to explore the benefits of guaranteed basic income to provide a cushion for personal and professional growth. Another California pilot program would provide guaranteed basic income to those who age out of foster care at 21 or older. The state should lower the eligibility age to 18 to account for the steep challenges in housing and employment Black youths face as soon as they become adults. Researchers at Stanford and other institutions have found that such policies support better health, housing security and employment prospects.
Addressing the deepening overdose epidemic in Los Angeles’ Black communities requires attention not just to the immediate risks to drug users but also to the childhood experiences that often drive them to use. One of our most powerful tools for preventing future overdoses is to take better care of the children most directly affected by today’s losses.
Jerel Ezell is an assistant professor of community health sciences at UC Berkeley who studies the racial politics of substance use.
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
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