A multitude of factors at the individual, societal, economic, environmental and other levels collude to foster high levels of violence in urban spaces. Similar to Covid-19, Trump and his team ignore important risk factors and causes of violence.
While they deny the existence of institutional and systemic racism, and racism as a determinant of urban violence, the evidence suggests that institutional and systemic racism may in fact be the necessary component, without which high levels of violence would not exist in urban spaces.
Violence and other forms of deviant behavior do occur in more homogenous and equitable societies. However, in developed economies and democratic societies, such high levels of violence and its geographic concentration as evident in the US do not exist.
In conceptualizing a model of disease causation, epidemiologists Rothman and Greenland suggest that a cause of disease is a condition, an event or circumstance that contains those characteristics without which a particular disease would not manifest. Their model is conceived of as a causal pie X, which consists of numerous slices or components which cause disease Y. The causal pie X is not a singular or a homogenous unit; rather, it is a multi-faceted pie and its slices interact to produce disease Y.
However, one of the slices within causal pie X is a necessary component, which must be present for a given disease Y to occur. The other slices of causal pie X could include an individual’s or group’s living conditions, the built environment, or social circumstances. In the context of understanding the pathology of urban violence in the US, could institutional and systemic racism be the necessary slice in the causal pie?
Covid-19 could be understood through a similar lens. Although the coronavirus (SARS-COV-2) is the necessary slice in the causal pie that produces the Covid-19 disease, an individual exposed to the virus may not contract or manifest Covid-19 because their living conditions and life circumstances shield them. Younger age, overall good physical health, high quality healthcare, low density household occupancy and the availability of personal protective equipment protect against the disease.
For example, despite exposure to the virus and testing positive for Covid-19, Baron Trump remains healthy and has not exhibited symptoms of the disease. Baron is shielded from Covid-19 because he is young, he lives in the White House with a billionaire father, and he has access to the best healthcare in the world. The built environment and social conditions shield the Trumps from the devastation of Covid-19, and Americans are thankful that the First Family has been spared the trauma endured by many other American families.
Congruent with continuous dismantling of the Affordable Care Act and anti-public health measures by Trump and his team, more than 225,000 Americans have been killed by the disease. Like Baron, how can we create suitable life circumstances and living conditions for other children in urban environments that make them resilient or grant immunity to the pathologies of Covid-19 and violence?
Employing the analogy of the light switch, Rothman and Greenland write “the causal mechanism for getting a light to shine involves more than turning a light switch to on.” The light switch in the ‘on’ position, although necessary for light, by itself does not cause the light to come on. In addition to the switch, the production of light requires a light bulb that works and electricity that flows through the circuit. If any of these factors are absent, there will not be light.
For many, the switch is considered the singular cause in the generation of light because it is the final factor that is observed in a complex causal mechanism. While the switch can be seen and touched, the wiring and other important components in the generation of light remain hidden from sight and conscious thought processes.
Institutional and systemic racism, experienced during early critical periods of a person’s life and endured throughout their life course, may be the necessary slice in the causal pathway to pulling the trigger and to the disease of urban violence.
In a similar vein, institutional and systemic racism, experienced during early critical periods of a person’s life and endured throughout their life course, may be the necessary slice in the causal pathway to pulling the trigger and to the disease of urban violence. One focuses on the trigger but ignores institutional and systemic wiring. Conservatives perceive causality in terms of reverse temporality, that is, for them, the symptoms are the cause of a disease, and not vice versa.
The twisted temporality of Trump and his team willfully ignores that urban violence perpetrated by individual actors is preceded by sequences of social events and conditions that mold individuals into whom they become. Ultimately, the conservative verdict is that repressive policing tactics can singularly and meaningfully contain acts of violence. The knowledge that the past influences the present and not the reverse, does not mean that individuals lack autonomy to determine their own actions or paths. However, in many ways, institutional and systemic racism reduce the chances for many individuals to take the appropriate path.
The interplay of institutional and systemic racism, social disadvantages and easy availability of firearms connive to produce extreme levels of violence; racism stands out as its singular most important factor. Rothman and Greenland highlight that the disease is based on the interactions of component causes and blocking any of these causes may result in the prevention of some cases of disease.
The idea that the urban environment would be a safe space despite serious structural violence committed against its populace is analogous to a visibly sick patient and their family’s hope that the lab result is negative when other evidence suggests that the disease has already been established.
As a society, we cannot only hope against the odds or employ police to flip the switch. Pulling the trigger and the ensuing darkness are symptomatic of broader American societal problems, buried deep within the wall of everyday racism. Thus, we can turn on the switch of the American social contract, to move from the darkness of violence and disease, to a more peaceful period where Americans live in safe spaces, free from violence and pandemic.
This election can be a point of rewiring the American social circuits and the dismantling of all forms of racism.
Danielle Taana Smith
Rothman, K.J., Greenland, S. 2005. Causation and causal inference in epidemiology. American Journal of Public Health. 2005;95 Suppl 1:S144-50. doi: 10.2105/AJPH.2004.059204. PMID: 16030331.