“Deaths of Despair” Drive High Mortality Rates in Semi-Rural California

Ignacio Valdez, a mentoring specialist for the Bakersfield social service agency Garden Pathways, leads a class for domestic batterers. Photo Credit: Chris Richard.

Dewey Welker has lots of dreadful memories.

With great clarity, down to the way his father turned up his shirt sleeves that day and the deep gray of his father’s jeans, he can describe every moment of being abandoned outside a liquor store at age 4.

He remembers stealing his first pair of shoes at age 7 and, a little later, beating up another boy to rob him of his scooter.

Marijuana came at 9, cigarettes at 12. His best friend introduced him to methamphetamine at 15.

That boy would later shoot himself.

More of Welker’s friends did that, or hanged themselves, or ended their lives in some other violent way. Others overdosed.

From his own young manhood, he remembers getting high in the bathroom, staying there for hours while his baby daughter cried outside.

He recites the rules to life in his Oildale neighborhood: women and girls do what the men say. If a girlfriend or wife even looks another man in the face, she might get a beating later. Men only respect cruelty. If you want something, take it by fear or force.

The life Welker, 27, describes so matter-of-factly might seem like a caricature of deprivation, violence and defeat, a horrific anomaly.

A pair of studies shows that in semi-rural communities like his, that kind of horror is common.

Last month, researchers at Virginia Commonwealth University’s Center on Society and Health and the University of Pittsburg’s Graduate School of Public Health reported that young and middle-aged white Californians are much more likely to die prematurely than are other residents of the state. Among the study’s findings:

  • Between 1995 and 2014, death rates from drug overdoses doubled among young and middle-aged whites in California.
  • Death rates from alcohol poisoning more than quadrupled among younger whites and increased more than 12 fold among whites aged 40 to 64.
  • From 2000 to 2014, the rate of suicides among middle-aged whites increased by 37 percent.

Such grim data reinforces findings of an earlier report by the same researchers, focusing on Fresno, Tulare, Kings and Kern counties. It found a death rate among white residents that was almost 40 percent higher than for other white Californians.

In Kern County, suicides by hanging, strangulation and suffocation among middle-aged whites increased by 133 percent during the study period.

Further, three communities in the county — Oildale, Kern River Valley and Taft — have some of the highest premature death rates in the state. The average life expectancy in these impoverished, majority-white communities is between 68 and 72 years, roughly eight to 10 years less than the national average, according to the report.

Researchers attribute the shortened lifespans to chronic stress associated with traumas such as child abuse or neglect, living with someone who has an alcohol or drug addiction or having a family member incarcerated.

Anthony Iton, senior vice president for healthy communities at The California Endowment,* called the statistics “shocking.” The nonprofit health foundation sponsored the research.

Other parts of the state have seen improvements in the rates of premature death of up to 40 percent in the last two decades, Iton said.

“And then you have Kern County, where the death rate has increased 30 percent in the same period,” he said. “The awful thing is, these deaths are preventable. They’re driven by self-inflicted harm, people committing suicide at rates that are really unprecedented, and then these passive suicides with alcohol and drugs.”

Iton calls such acts of self-destruction “deaths of despair.”

“We’re having on-going conversations with (Kern County) health officials, but this is not just a health officials’ problem,” Iton said. “We haven’t heard from the political leadership as far as much concern, or assertive policy efforts to try to address what’s going on.”

Iton wants to start with what he envisions as a Marshall Plan-style effort to revitalize Kern County’s economy. The region has some of the severest poverty in the state.

Still, Derek Chapman, associate director for research at the Center on Society and Health, wonders what other factors may be at play.

“We have other areas that have just as much poverty, or populations with hundreds of years of oppression, and they’re not turning to these high rates of suicide,” he said.

The Kern County supervisors representing communities with some of the highest death rates did not respond to interview requests.

But Bakersfield Mayor Karen Goh questions whether increasing employment opportunities is the place to start. She noted that The California Endowment has repeatedly identified the emotional and psychological damage of trauma as a leading public health risk.

“What we’ve come to see over time, as we work with these high-risk populations, is that unless we deal with the trauma, it can be hard to move on,” she said. “What we’ve found, and what the research is showing, is that we have to deal with the trauma before the employment piece.”

Bill Phelps, chief of programs at Bakersfield-based Clinica Sierra Vista, a nonprofit health care services agency, also looks to the lasting effects of childhood traumas in the population he serves.

“We’re looking at trauma-involved care, how childhood events impact the life course of each person,” he said.

“People who have undergone multiple traumatic events tend to be more socially isolated and just to make poor decisions and have less-developed coping skills. We’re a long way from figuring out how we’re going to prevent this, because we have to figure out how we’re going to eliminate these social woes that just seem to plague us, and, in recent years, seem to be getting worse.”

That leaves social service agencies like his trying to repair the damage, one person at a time, Phelps said. Getting traumatized people into a behavioral health or mentoring program can help a lot, he said.

Goh said local officials also are working on systematic ways to address trauma in children and head off some of its consequences. For instance, local government officials are working on protocols whereby police can notify school officials if they have to intervene to stop domestic violence at a student’s home. The idea is to have a well-briefed team of law enforcement and educational officials prepared to respond to the trauma, Goh said.

In addition to her mayoral duties, Goh is chief executive officer of Garden Pathways, a Bakersfield nonprofit that serves families making transitions from welfare and child protective services programs, persons impacted by gang violence and abuse, ex-offenders, foster youth and  pregnant or parenting teens. The organization pairs clients with mentors for programs ranging from job training, to parenting skills, to anger management.

Describing a typical client, Goh recalls a young man who, at age 8, knew how to iron his drug-dealer father’s wads of cash and how to render first aid to a person suffering a heroin overdose.

“We had to start by helping him process memories like that,” she said.

Juan Avila, Garden Pathways’ chief operating officer, said the emotional bonds between clients and mentors are crucial. Unlike other programs, Garden Pathways mentors regularly allow clients who arrive intoxicated at a program session to remain. So long as the person is not disruptive and poses no danger, a mentor may simply direct the person to a couch, Avila said.

“We had a client who did that a lot, but who did turn out a success, and at one point he asked his mentor, ‘Why did you let me stay when I was high?’” Avila recalled. “The mentor said, ‘I’d rather have you there, safe, for four or six hours, then to have you out on the street and not know what’s going to happen to you.’ It’s really about the relationship.”

To show that approach works, Avila cites Garden Pathways’ performance on a federal Labor Department grant for parolees. Clients who participated in the program often struggled to find employment, Avila conceded.

He points to what he considers a more significant indicator. In general, the rate at which California’s ex-convicts re-offend and are re-incarcerated has sometimes exceeded 65 percent. For the Garden Pathways clients in the jobs program, the recidivism rate was just 13 percent. The Labor Department has approved a second grant proposal that concentrates on recidivism, Avila said.

“We asked them why and they told us, ‘You all believed in us, and we didn’t want to let you down,” he said.

Dewey Welker, the young man with the dreadful memories, also speaks about his relationship with Avila and Garden Pathways in terms of the freedom that friendship brings.

He says he hasn’t seen his father since the day he found himself alone outside that liquor store. They did speak recently on the telephone, shortly after his father found out he’s terminally ill. Welker said he’d hoped the man would show some remorse, or even explain what he’d done.

He didn’t. Welker let it go.

He regularly attends anger management classes. He’s been sober for more than two years.

“There’s other ways of doing things, you know?” he said.

“That’s what I want to do. I want to change my family. I can’t personally change them. But I can show them.”

*The California Endowment is a funder of California Health Report

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