Map of life expectancy at birth from Global Education Project.

Thursday, January 02, 2020

Personal Responsibility

A fundamental assumption of libertarianism, and of ordinary conservatism, is that people's lot in life is generally deserved. Poor people, substance abusers, offenders -- they didn't work hard enough, they are moral failures, they don't love Jesus, whatever, it's their own fault. People who are economically and socially successful earned what they have. Social problems are individual problems -- if we try to help the unfortunate, we just enable their failings.

Back in the 1990s (while Bill Clinton was president) the CDC cosponsored a study with Kaiser-Permanente on what are called Adverse Childhood Experiences (ACE). Sure, we all have adverse experiences in childhood and right on through life. But it's a matter of degree. An official ACE doesn't mean you fell and broke your arm, or even that a bully stole your lunch money or your crush didn't like you back. ACEs are really traumatic experiences, such as witnessing or experiencing serious violence -- including being a victim of abuse -- having a family member attempt or complete suicide, and living in a family with mental illness or addiction. CDC offers a brief fact sheet here.

You might be surprised how common these are. More than 60% of people report having experienced at least one, and some 16% reported four or more. Here's the big point: these are strongly associated with problems in adulthood. To quote the CDC fact sheet:

ACEs can have lasting, negative effects on health, well-being, and opportunity. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems, teen pregnancy, involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.
ACEs and associated conditions, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress from ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress.
Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.
The associations are complex and multifarious -- they can't be neatly summarized. If you're interested you can find a bibliography here. But the point is, we don't make ourselves. Sure, some people overcome adversity, but they generally do it with a lot of help. The world is not naturally just. Our lot in life has a whole lot to do with the good or bad fortune of our childhood. And children are not at fault for what happens to them. We have to make justice, and that means taking affirmative action.

13 comments:

Woody Peckerwood said...


A great dream, but I don't think you've thought this through. It's unworkable even if you could convince anyone that this kind of AA was a good idea.

How would you qualify? What would be the remedies? The cost would be staggering.

What is the potential for abuse?

And if these experiences are normal (based on the fact that the majority of the population has experienced them), why is this not just another wealth transfer scheme?

Cervantes said...

Well Pecker, I think you're largely missing the point. I do certainly argue that we need to make mental health and substance abuse treatment services for adults much more accessible and available, and stop criminalizing behavioral health problems. We'd actually save money if we stopped incarcerating people and started treating their problems. But the even stronger point is that we need to invest in children and prevent these problems. I look at it from a public health perspective. There wouldn't be a cost, there would be a huge profit to society. The cost we already bear, in lost productivity and damaged lives.

Woody Peckerwood said...


Sir, I agree with your goal.

But having the state "invest" in children seems inefficient and probably financially impossible to achieve the results you want.

The state can't watch them or identify problems early enough. We just don't have the resources and we will forever be trying to "fix" them instead of teaching them from the start. Then you also will have the "big brother" problem in selling these ideas to the people.

A better and more efficient way and one that would cost little to nothing would be for the state to promote social policies that encourage two parent homes, particularly homes with a strong male role model since most violent crime is committed by men. Homes and institutions that could transmit our best values to these children instead of the internet, television and Hollywood.

That used to happen...

Don Quixote said...

WP's last comment seems to indicate a strong "Christian" perspective. I could be wrong. But Christianity is responsible for as much as of the carnage in the world as any other force, if not more carnage.

I knew a woman in her 60s, then 70 and 80s, who was a terrific role model. Her secret? I think it was the love of her father, who raised her as a single dad.

One terrific parent will do the trick. Two great parents--ideal! Two parents where one is an active alcoholic, for instance? Far from ideal.

The need for two parents is a myth, though two excellent parents seems great. Two great parents in the context of a larger community with extended family seems good. The automobile- and fossil-fuel-based society has largely destroyed that--in addition to making the extinction of Homo sapiens a reality.

Cervantes said...

Sadly, I don't know what sort of "social policy" would bring about two parent homes with "strong male role models." Much of the risk for ACEs is economic -- poverty, endemic violence in the community. Some of it is just bad luck, a parent with mental illness or SUD, a family suicide, a "strong male role model" who rapes you. . .

But there are various potential effective measures. One is actually mandated by Medicaid, it's called Early and Periodic Screening, Intervention and Referral. That is, pediatricians should screen kids for trauma and behavioral health problems and then have appropriate responses available. But it doesn't happen in every state and of course most children aren't Medicaid beneficiaries, although probably many of the most at-risk kids are. All children need good schools, with effective social services. Right now many schools respond to troubled children with disciplinary action or suspension, which is totally counterproductive. There needs to be employment opportunity, recreational opportunity, community building measures, urban green space. There's a lot we can do but you can't just wave a magic wand and create good environments for every child.

Woody Peckerwood said...


This is just common sense. You really don't need anyone to tell you that it's better to have two parents. Better psychologically, better economically, better educationally...can't really think of a negative to having a two parent family as opposed to a single parent environment for children. Can you?

How to encourage this is a good question and an issue up for debate. What's not up for debate is the value of accomplishing these goals. You seem to be a big government guy. Perhaps you have some ideas on this.


https://www.bbc.com/news/education-47057787

In this research, even allowing for economic disadvantage, Prof McLanahan said, data began to show the impact of instability on a child's life.

Those whose parents had divorced were more likely to fail to progress at school.

Children who were in what the researchers characterised as a "fragile family", where parents were cohabiting or there was a lone parent, were twice as likely not to graduate from high school.

Prof McLanahan said the data showed that even a child in a stable single-parent household was likely to do worse on some measures than a child of a married couple.

"Having two adults who co-operate to raise the child, who give time and money, means there are just more resources than one doing it," she said.

Cervantes said...

Look, I don't disagree with that. But what are you proposing to do about it?

Woody Peckerwood said...


Benefits for...and disadvantages against. The same way everything else is promoted or discouraged.

Maybe promote marriage both through government benefits and socially. Stop allowing single parents to "marry" the state through the welfare system. Less tax breaks for parents that have "no fault" divorces.

Those might be be a start...

Take a lesson from the anti-smoking campaign - make it cool to be a married couple with kids.

Cervantes said...

Alas, it's much more complicated. In the first place, the "welfare" system you are referring to is long gone. It is not possible for parents to receive long-term support without working. What used to be Aid to Families with Dependent Children was changed to Temporary Assistance for Needy Families back in the Clinton Administration. The large majority of poor parents are working. Medicaid and SNAP help, but they aren't getting income support.

And it's generally better in many cases for parents to divorce than to remain in loveless or even abusive marriages. One reason that children of single parents tend not to do as well is because their parents fought, or one was abusive or mentally ill or an addict, so they got divorced. Keeping them together in that situation is harmful, not helpful.

ACEs, in other words, may be a cause of divorce, but the divorce itself is the better alternative. I should add that economic distress is a common contributor to marital stress and divorce. So if you want to reduce the divorce rate steps you can take are some of the ones I already listed. Access and availability of substance abuse and mental health treatment, including family counseling; economic opportunity. But let's face it, some marriages just don't work out. And of course ACEs happen to kids in intact marriages as well.

Cervantes said...

BTW, this is from the Wikipedia entry on TANF:

The TANF program, emphasizing the welfare-to-work principle, is a grant given to each state to run their own welfare program and designed to be temporary in nature and has several limits and requirements. The TANF grant has a maximum benefit of two consecutive years and a five-year lifetime limit and requires that all recipients of welfare aid must find work within two years of receiving aid, including single parents who are required to work at least 30 hours per week opposed to 35 or 55 required by two parent families. Failure to comply with work requirements could result in loss of benefits. TANF funds may be used for the following reasons: to provide assistance to needy families so that children can be cared for at home; to end the dependence of needy parents on government benefits by promoting job preparation, work and marriage; to prevent and reduce the incidence of out-of-wedlock pregnancies; and to encourage the formation and maintenance of two-parent families (Smith, 2010).

Woody Woodpecker said...

So, how's that working?

https://www.cbpp.org/tanf-at-20

I wish government programs like this worked as well as you think they do.

I don't think they're the answer in the long run.

Anti-smoking campaign tried to tell people of the health risks. Cancer, stroke, bad teeth, heart disease. That didn't work as much as making it cool not to smoke.

It's got to be Cool to be married when you have kids. Cool to learn a trade. Look up to those who have overcome the same problems. Gotta make it cool.

A cultural shift is the real answer.




Cervantes said...

I actually never did think that TANF is any good. I was just pointing out that the kind of welfare you thought existed doesn't. And again, a cultural shift that encourages people to stay in bad marriages with abusive or otherwise unfit partners is not going to help children. The reason people get divorced is not because they think it's "cool." I note that you have apparently changed your name.

Eddie Pleasure said...

This discussion assumes that there are children. Maybe we should start before that happens...
In Wisconsin, Human Growth and Development (sex education) is NOT required. If a school district decides to offer this instruction, it allows parents to opt out of getting the instruction, and there are state laws to be followed.

Here is a snapshot of the current rules in the state statutes:

118.019  Human growth and development instruction.
Required subjects. If a school board provides instruction in any of the areas under sub. (2) (a), the school board shall ensure that instruction conforms to s. 118.13 (1) and that the following is provided, when age appropriate, in the same course and during the same year:
(c) Presents abstinence from sexual activity as the preferred choice of behavior for unmarried pupils.
(d) Emphasizes that abstinence from sexual activity before marriage is the only reliable way to prevent pregnancy and sexually transmitted diseases, including human immunodeficiency virus and acquired immunodeficiency syndrome.
(e) Provides instruction in parental responsibility and the socioeconomic benefits of marriage for adults and their children.
(f) Explains pregnancy, prenatal development, and childbirth.
(g) Explains the criminal penalties under ch. 948 for engaging in sexual activities involving a child.
(h) Explains the sex offender registration requirements under s. 301.45. Instruction under this paragraph shall include who is required to report under s. 301.45, what information must be reported, who has access to the information reported, and the implications of being registered under s. 301.45.
(i) Provides medically accurate information about the human papilloma virus and the human immunodeficiency virus and acquired immunodeficiency syndrome.

So, a lot of finger wagging and health scare information.

Also this: 10. Adoption resources, prenatal care, and postnatal supports.

Nothing about contraception is required. It is not clear to me if there is a penalty if contraception is discussed.

Lack of education, cuts to Planned Parenthood, and the continued push to exclude prescription contraception from health care plans means that people will be, well, people, and will reproduce whether it is in their best interests or not.