(250008)

There’s a 20th century proverb that speaks tothe inevitable peril associated with gang culture.

“Live by the gun, die by the gun”

This is more than a stale one-liner that you might hear at the end of a didactic Clint Eastwood film.

These words encapsulate a lifestyle, and for many, a birthright.

A recent investigation by ProPublica highlights a study of hospital patients in inner-city communities in Atlanta that revealed rates of Post Traumatic Stress Disorder (PTSD) symptoms comparable to those seen in veterans of the Vietnam, Afghanistan and Iraq wars.

At least one in three respondents reported that at some point in their lives they had experienced PTSD symptoms – an array of stress responses including flashbacks, persistent feelings of fear or shame, a sense of alienation and aggressive behavior. (The nationwide PTSD rate is about 7 to 8 percent, with generally higher rates among Blacks and women.)

During the first presidential debate last year, Democratic nominee Hillary Clinton offered a harrowing statistic on firearm homicides and the victimization of Black males.

“The gun epidemic is the leading cause of death of young African American men, more than the next nine causes put together,” she said.

Data from the Centers for Disease Control and Prevention confirms her assertion: Of all Black males between the ages of 15 and 24 years that died in 2014, a majority – 54 percent – were killed by a gun.

Nearly nine in 10 gunshot deaths among young Black men were homicides. When young White men die from a gunshot wound, the cause is usually suicide.

Beyond the direct victims of shootings and assaults, those affected include the loved ones who often struggle to help family members cope with, for example, a spouse’s debilitating panic attacks or a child’s unrelenting nightmares. And they typically carry this weight within a landscape rife with poverty, often without a hospital, much less a psychiatrist’s office, nearby.

The prevalence of these psychological ripple effects suggests that in some neighborhoods, nearly every family is touched by traumatic violence.

Among the most trauma-ridden neighborhoods are impoverished communities of color where inequality fuels hopelessness. That drives vulnerable youth deeper into violence, both as victims and as perpetrators. Studies on youth have traced PTSD symptoms back to forms of violence – from street shootings and police chases to sexual assault – that have become routine in rough city neighborhoods.

Some experts say that the high victimization rate of young Black men is under-covered because most Americans think that gun violence doesn’t affect their lives. Michael Nutter, a former Philadelphia mayor and now an urban policy professor at Columbia University, told The New York Times in 2015 that the public would care more if Whites were dying from gun violence at the same rate as Blacks.

“The general view is it’s one bad Black guy who has shot another bad Black guy,” Nutter said. “And so, one less person to worry about.”

The violence is pronounced in urban areas. In Chicago, for example, the risk of getting shot in the most dangerous neighborhood is nine times greater than in the safest neighborhood, and the shootings are clustered in districts that are populated predominantly by low-income Black people.

Chicago is one of many large American cities where gun homicides spiked last year. The victims were disproportionately young, male and Black.

In a study on Chicago’s Cook County Hospital – which tends to thousands of gunshot victims each year – more than 4 in 10 patients screened showed symptoms of PTSD, with an even higher rate among those wounded by guns.

A survey by the Family-Informed Trauma Treatment Center (FITT) of inner-city youth – who are disproportionately Black and Latino – reveals that more than 80 percent have experienced “one or more traumatic events.” And their struggles tend to deepen over time because of a lack of accessible culturally appropriate mental health treatment.

Sebastian Henagulph, forensic psychiatrist at the Mid-Atlantic Wellness Institute and Westgate Correctional Facility, cited British research that reported gang membership can lead to mental illness.

“It’s a two-way thing. A lot of people who end up in prison have antisocial personality disorder or other personality disorders,” Henagulph said. “Usually 5 to 10 per cent of the population has a personality disorder, but if you go into a prison, you’ll find 60 to 80 per cent with a personality disorder.”

One study found that nearly 90 percent of gang members had antisocial personality disorder, compared with 30 percent of violent men with no gang affiliations and only 10 per cent of non-violent men.

“Some people get involved in these gangs because of the general stressful environments they’re in,” Henagulph said.

He added that the racial divide played a part in gangs, with the majority made up of young Black men.

“It tends to be people on the margins of society. The disenfranchised don’t have money and don’t see hope in their lives, and drift into the gang lifestyle. Historically, the Black population has been at the lower end of the socioeconomic spectrum.

“Generally, most of us deal with stress in a healthy way whereas other people might not have these same coping skills and resort to drugs and alcohol, blaming other people and fighting other people.”

Henagulph added that in addition to poor mental health contributing to gang affiliation, membership could contribute to deterioration in mental condition.

“Some of the people in gangs, because of the violence they’re committing and the stressful environments they’re in, are paranoid all the time because someone is actually probably coming to get them,” he explained. “Just being in the gang gives you anxiety, depression, post-traumatic stress disorder and high rates of suicide.”

The chaos that seems to haunt so many urban neighborhoods does not start with the pulling of a trigger. It represents the fallout of decades of underinvestment in neighborhoods where schools, health care and social services are chronically deprived – the brutality of the everyday, with no bullets, just innocent targets.