About the authors
Kristin Mmari is an assistant professor at the Johns Hopkins Bloomberg School of Public Health.
Robert W. Blum is the William H. Gates, Sr. professor at Johns Hopkins Bloomberg School of Public Health and chair of the Department of Population, Family and Reproductive Health.
Beth Marshall is an assistant scientist at the Johns Hopkins Bloomberg School of Public Health and the associate director of the Center for Adolescent Health.

Youth in Baltimore feel less social support than those in other poor, urban centers around the world. (AP Photo/Matt Rourke)

The unrest in Baltimore that followed the funeral of Freddie Gray was not entirely unexpected. For those of us who live and work in Baltimore and other economically distressed urban environments, these outcries of injustice are familiar. We saw it in Los Angeles in 1965 and 1992, in Detroit in 1967, in Ferguson in 2014, and even in Baltimore back in 1968. While the triggers may vary, the underlying causes are the same — persistent disadvantage and a prevailing sense of hopelessness.

[Live updates: Protests in Baltimore]

Poverty is global problem, but how it affects young people’s sense of hope and well-being is not universal. Teenagers in Baltimore face poorer health and more negative outlooks than those in urban centers of Nigeria, India and China. That’s what we discovered in a study we published last year comparing the hardships and attitudes of teenagers in Baltimore to those in other economically distressed areas of Johannesburg, South Africa; Ibadan, Nigeria; Shanghai, China; and New Delhi, India. The study revealed that, for young people growing up in poverty, living in a high-income country mattered far less than the social support they receive in the immediate neighborhoods where they develop and grow.

For one aspect of the study, we asked youth aged 15 to 19 years old in each urban location to take photographs that depicted the meaning of health (or ill health) in their neighborhoods. Youth at every site illustrated the idea similarly, taking photos of the garbage and dirt that plagued their communities.


Youth in Baltimore (left) rate their physical environment as worse than those in Ibadan, Nigeria (right).

But when we asked them to rate their physical surroundings on a scale of 0 to 14 (with a lower number representing a poorer perception of the environment), those in Ibadan and Shanghai had more positive feelings about their communities than youth in Baltimore. Adolescents in Baltimore and Johannesburg also had the highest frequency of witnessing community violence and the lowest sense of social cohesion.

Male respondents


 

Female respondents


There were other striking differences.  Across the five cities we studied, adolescents in Baltimore and Johannesburg also experienced the highest prevalence of health problems, including high levels of victimization, sexual violence, substance abuse, depression and PTSD. Importantly, adolescents in both of those sites also held the poorest perceptions about their communities.

Though youth in Baltimore experience similar levels of physical decay as those in other poor urban communities around the world, they feel worse about their environments. This may suggest that witnessing community violence and having a low sense of social support may be especially relevant in determining the health and well-being of adolescents in disadvantaged urban environments.

That feeling of a lack of social support extended to law enforcement. Shockingly, over 80 percent of Baltimore youth in our study had little or no trust in the police, the justice system, the broader government, or other public authorities. A quote from a young person in our study summarizes this lack of trust:

Interviewer:  So, why don’t you feel safe in your community?

Participant:  I think the way the mayor put more police officers made it worse.

Interviewer:  OK. Why do you think it made it worse then?

Participant:  Because now like… People already didn’t like the police, but now it’s like they want to retaliate even more just because they’re harassing them a lot more than they used to be. Like say, you don’t got drugs on you or something like that and they stop you one day, then they stop you the next day, then they stop you the next day and like their anger is building up towards the police so they want to retaliate.

Interviewer:  OK. And so the police doesn’t make your neighborhood feel any safer or you said, it feels like it’s making it worse?

Participant:  Right, because they’ll stop out of nowhere. Say they’re cruising, then they’ll just go zooming and pull up into the park and then just start chasing people. Somebody could…a little baby could have gotten knocked down in the park or anything. And then they’ll chase the boys on their mopeds and stuff like that. And then the mopeds will come through the park while my nephew is in there. My nephew could have gotten hit by a moped or something like that. They just make it worse.

Urban decay, violence, and the lack of support and trust in adults are some of the underlying factors fueling the unrest in Baltimore. while racial discrimination is no longer legal in the U.S., economic discrimination can have as much impact as a “Whites Only” sign. There are other forms of economic discrimination that manifest in such environments: Young people progress through schools without learning the skills sufficient to obtain living wages. Single parents must work two or three jobs to feed and shelter their families. Young people grow up without any successful role models. The result is that everyday life for some of these young people is so traumatic that the rates of PTSD match those of combat veterans.

Given that such a large proportion of the rioters in Baltimore were teenagers and young adults, it’s important to understand the environment these youths are growing up in. It’s important to hear their concerns and address the problems that plague their communities. It’s important to provide the social support that can end the cycle of hopelessness. Simply living in a wealthy country doesn’t give young people the opportunities they need to feel optimistic about their futures. If we want to end the perpetual uprisings in our urban communities, we must stop turning a blind eye to the injustice right in front of us.

More from PostEverything:

What caused the Ferguson riot exists in so many other cities, too

We shouldn’t condone the Baltimore riots, but let’s stop calling them ‘senseless’

Black people had the power to fix the problems in Ferguson before the Brown shooting. They failed.