EDITORIAL

Violence, Stress, and Compromised Health

Frank Hutchins[1]

1. Bellarmine University.

Doi: https://doi.org/10.16921/pfr.v8i3.299

PRÁCTICA FAMILIAR RURAL│Vol.9│No.1│Marzo 2024│Recibido: 20/03/2024│Aprobado: 23/03/2024

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Abstract

The increase in violence in countries such as Ecuador, where organized crime, drugs, human smuggling, and political venality produce daily eruptions, has measurable consequences for human health. The skyrocketing homicide rate (from 7.7/100K in 2020 to 44.5 in 2023) (Statista 2024), along with increases in violent robberies, kidnapping, carjacking, and sexual assault, mean direct experiences with harm or death. Since 2021, over ten states of exception, and the existence of an “internal armed conflict,” have been declared in Ecuador.

Keywords: violence, stress, health, allostatic load

Violencia, estrés y salud comprometida

Resumen

El aumento de la violencia en países como Ecuador, donde el crimen organizado, las drogas, el tráfico de personas y la vanlidad política producen irrupciones diarias con consecuencias mensurables para la salud. La creciente tasa de homicidios (de 7,7/100.000 en 2020 a 44,5 en 2023) (Statista 2024), junto con el aumento de los robos violentos, los secuestros, los robos de vehículos y las agresiones sexuales, implican experiencias directas de daño o muerte. Desde 2021, se han declarado en Ecuador más de diez estados de excepción y la existencia de un “conflicto armado interno”.

Palabras clave: violencia, estres, salud, carga alostática

 

But the potential for harm – physical, sexual, psychological, or financial – can also exact a toll on wellbeing that is more challenging to quantify.  A constructive language is evolving that offers help in recognizing and responding to the consequences of these more indirect forms of violence. Concepts such as embodiment theory, weathering, allostatic load, and stress neurobiology address the buildup of intersecting stressors that may be masked by the more attention-grabbing violent crimes.

It’s no mystery that chronic stress impacts health, manifesting in high blood pressure, heart disease, stroke, obesity, and diabetes. As Ecuador surges into the top three of the most violent countries in Latin America, public health officials need to focus research and treatment resources on both immediate and longer-term health problems.

According to McEwen, social experience shapes the brain and body epigenetically. He argues for an exchange of ideas between sociology and stress neurobiology in response to toxic stress and its epigenetic consequences. Experiences with poverty and violence can affect the architecture and plasticity of growing brains, increasing the chance that inequality is passed down through the generations. (McEwen 2022)

Violent neighborhoods can also create metabolic disorders. A study done on Mexican adolescents living amidst poverty and violence found a significantly higher percentage with prediabetes. “(T)here is a consistent finding of more affected endocrine markers in those with exposure to violence compared to their peers without exposure. In fact, these social determinants cause severe psychological stress that could promote a pro-inflammatory state leading to metabolic impairment, including prediabetes.” (Hernandez-Montoya, Cedillo-Escobar et al. 2022)

This collection of biomarkers becomes visible and measurable during an individual’s lifetime, but it can also be documented in death. According to embodiment theory, people exposed to prolonged physiological stress “biologically incorporate the societal and ecological circumstances of their world.”  (Litavec and Basom 2023) Dental and skeletal evidence collected during forensic analysis reflect the end result of structural vulnerability.

The weathering hypothesis similarly argues that chronic exposure to certain social and economic conditions has identifiable health consequences. This can be used to explain persistent health disparities, including large differences in average lifespan within a single community. Birth outcomes can also be negatively impacted by these conditions. (Forde, Crookes et al. 2019)

In addition to real and perceived threats of physical violence, harm also occurs as a result of extortion, migration, and degradation of the environment. Extortion and human smuggling have become significant sources of income for criminal gangs. From 2022 to November 2023, Ecuador experienced an over 65% increase in extortion cases, which is an almost 400% increase from 2021. (ACAPS 2024).

Fredy Rivera Velez, a security and strategic studies professor in Ecuador, told InSight Crime that extortion has created an “environment of fear” that hits business owners particularly hard. “Before, if you said, ‘I am a member of the Choneros,’ people would not have paid any attention; people would have ignored your call,” Rivera told InSight Crime. “Now, a call like that generates an instant feeling of fear.” (Austin 2023)

Violence of the types discussed above is extensive across space and time, and has led to the displacement of growing numbers of people who decide to flee. Migrants may eventually arrive in more peaceful environments, but there are real short-term impacts on them and their families. The psychological and physical effects of traversing dangerous landscapes, and the sense of loss felt by those left behind, can be traumatic.

All of the above factors, and certainly others, present potential public health threats. There is no indication these will subside in the near future. The Global Risk Forecast 2024 predicts this will be another violent year for Ecuador. The gunshot wounds, beatings, and sexual assaults leave immediate evidence of the impacts of this wave of violence. But the stress and anxiety, sometimes simmering and sometimes boiling over, has real health affects as well. It’s crucial to identify and respond to these threats.

Referencia bibliográficas

ACAPS (2024). ECUADOR: Increased violence amid internal armed conflict leads to protection concerns, ACAPS.
Austin, A. (2023). Why Have Ecuador's Drug Trafficking Gangs Turned to Extortion?, InSight Crime.
Forde, A. T., et al. (2019). "The weathering hypothesis as an explanation for racial disparities in health: a systematic review." Annals of Epidemiology 33: 1-18.
Hernandez-Montoya, D., et al. (2022). "Undiagnosed prediabetes in Mexican adolescents under poverty in contexts affected by collective violence: A clinical comparison among health services users and hidden population." Frontiers in Nutrition.
Litavec, H. and R. L. Basom (2023). "Incorporating a structural vulnerability framework into the forensic anthropology curriculum." Forensic Science International: Synergy 6.
McEwen, C. A. (2022). "Connecting the biology of stress, allostatic load and epigenetics to social structures and processes." Neurobiology of Stress 17: 1-8.
Statista (2024). Homicide rate in Ecuador from 2014 to 2023. Statista, Insight Crime.