Hello. Welcome. I'm thrilled that you've decided to join me in this course. Violence, conflict and trauma and social determinants of health. I'm Barbara Peterson and I'm the instructor. I'm eager to teach this course and work with you through this module. The Module has three parts and in our first part we're going to examine the prevalence of violence and conflict, and the relations between social determinants of health and conflict to increase the knowledge of the bidirectional effects of trauma and social determinants of health. So, in the module, we have two other parts and we will be working on the Learning Objects 2 and 3 on this slide in those future parts to the module. Let's look again at the data to Action Model. This module is aligned with the data to Action Model in identifying and naming ways in which trauma, violence and conflict, and social determinants of health are interconnected and through sharing, and incorporating knowledge about these issues. Lastly, the module will identify ways that systems across the globe are creatively addressing these issues in their communities. Let's then look at the definition of trauma. Trauma is an event or series of events or set of circumstances that is experienced by an individual or group of people that's physically or emotionally harmful or life threatening and that has lasting adverse effects on the individuals functioning and mental, physical, social, emotional or spiritual well being. Some types of trauma for us looking at acute trauma. This is the individual one experience of trauma that a person may have that causes some acute traumatic responses. This might be being in a motor vehicle accident or witnessing a serious accident happened to someone else. We also look at chronic exposure to trauma. These are the intentional acts of violence or that happen in a community, for instance bullying or fights among gangs or warlike conditions, or terrorist attacks, things like that. Where there it's a chronic traumatic experiences that are experienced in the community and then the next one is complex trauma. We usually think about complex trauma is happening, beginning to happen in with children in children's exposure to multiple traumatic events that have an accumulation effect. And these events are usually invasive and interpersonal in nature, and can have long term effects from complex trauma. Secondary historical trauma is or generational trauma are those traumas that get passed down from generation to generation. There are those traumas that are deeply embedded into the social fabric of a culture and get passed down from one generation to the next. And then we look at vicarious trauma, also known as secondary trauma, which is experienced by people like first responders or mental health professionals whose experience trauma secondarily through working with patients or working with a person who is in the middle of a trauma and helping them, or maybe listening to a person's traumatic experience. And then secondarily experiencing it as well. Global prevalence of trauma. Looking at natural disasters that claims 60,000 deaths annually. Those are floods, earthquakes, droughts and fires. Looking at injuries that claim 5.8 deaths annually, injuries are things like traumatic injuries, like road traffic crashes, drownings, falls, burns, fires, things like that, that claim a significant number of deaths here. We also look at war and homicide, and suicide, and poisoning. So here is the WHO Global estimates of traumatic events globally. Homicide is the 6th leading cause of death. And in fact in Latin America countries, it is the leading cause of death in people age 15- 49.Twice as many young adults die from homicide as from road accidents. And then we want to Look at trauma in vulnerable populations. First looking at trauma in older adults, injuries from accidents or mistreatment or falls really take a toll on the well-being of older adults. One in 17 older adults report abuse in the last month and almost two million die from injuries millions more sustained debilitating nonfatal injuries. Eight million adults in the United States then suffer from post traumatic stress disorder every year. And we are learning that symptoms of post traumatic stress can emerge decades after the person has experienced the trauma and sometimes for the first time when a person becomes an older adult, when that happens, the symptoms can be even more extreme. Looking again at trauma in vulnerable populations, we can look at trauma experienced by women, especially reports of being a victim of sexual abuse or physical or sexual violence by an intimate partner. So the staggering number of women suffer from this kind of trauma. Okay, looking then at vulnerable populations in such as children, more than 2,000 children die every year from preventable injury. And 95,000 children and adolescents were killed by homicide annually. So we look at these statistics on this screen and and are shocked at the number of traumatic events that are experienced by children. We have begun to assess adverse childhood events or ACEs in children. What are adverse child events or ACEs? Well, this refers to multiple types of abuse, neglect, violence between parents or caregivers or other kinds of serious household dysfunction such as alcohol or substance use. Also, it includes peer or community or collective violence. It's been shown that considerable prolonged stress in childhood can have a lifelong consequence for a person's health and well being. As we see, the more ACEs that a person experiences the more disease disability, and early death is seen in people who have adverse childhood events or ACEs. In fact, multiple aces have a huge effect on emotional health, substance use and also physical health such as cancer, heart disease, respiratory disease, obesity and diabetes. The impact of COVID 19 has been significant as far as experiences of trauma. A study that you'll read about in your readings is looking at Reddit and Twitter posts in adolescence. The number of abusive messages increased in all countries that were studied, there were 15 countries that were studied all countries except Sweden. The growth was particularly significant in Indonesia, the Philippines, Portugal and Brazil with a more than 30% increase compared to Pre-COVID times. One possible explanation could be due to the stay at home orders or measures especially with adolescents where they were actively using twitter. But the gross of abusive content has been very significant in Twitter and in Reddit. So in summary trauma is an event or series of events or circumstances experienced by an individual or group that has physical, or emotional harmful or life threatening and adverse effects on a person's functioning. So as we look at trauma, there's a reflective exercise that I'm asking you to do and that is to look at the four types of trauma that I have listed here. And identify some examples from your community of acute chronic complex, historical or racial trauma that are experienced in your community and got some of those traumatic experiences down. I hope you've enjoyed this part of the module and the next power point will have for you will be for Part two. I hope you enjoy the readings and your learning. Thank you so much.
