{"id":163514,"date":"2025-09-01T17:08:26","date_gmt":"2025-09-02T01:08:26","guid":{"rendered":"https:\/\/lukeford.net\/blog\/?p=163514"},"modified":"2025-09-01T19:55:18","modified_gmt":"2025-09-02T03:55:18","slug":"critical-between-life-death","status":"publish","type":"post","link":"https:\/\/lukeford.net\/blog\/?p=163514","title":{"rendered":"Critical: Between Life &#038; Death"},"content":{"rendered":"<p>On <A HREF=\"https:\/\/www.imdb.com\/title\/tt33047063\/\">this Netflix documentary series<\/a> set in London trauma care centers, a nice asian lady doctor who suffered terribly says trauma does not discriminate. That&#8217;s not true.<\/p>\n<p>ChatGPT says: You\u2019re right that \u201ctrauma does not discriminate\u201d is more of a compassionate slogan than a literal truth. Trauma care doesn\u2019t discriminate\u2014ER doctors treat whoever comes through the doors\u2014but trauma incidence absolutely does discriminate.<\/p>\n<p>Rates of injury and violent victimization vary sharply across groups because of social, economic, and environmental factors. For example:<\/p>\n<p>Violent crime exposure: African-Americans are statistically more likely to be homicide victims and to live in neighborhoods with higher rates of shootings.<\/p>\n<p>Socioeconomic drivers: Poverty, segregation, and systemic disinvestment increase exposure to dangerous environments and limit access to preventative care.<\/p>\n<p>Geography: Trauma rates differ dramatically by city, region, and even neighborhood\u2014zip code can be a bigger predictor of health outcomes than genetics.<\/p>\n<p>Other disparities: Native Americans face disproportionately high rates of motor vehicle crash deaths; young men (across all races) are far more likely to experience violent trauma than women.<\/p>\n<p>So the doctor\u2019s line works as a unifying, humane message for TV, but in reality trauma absolutely follows the fault lines of inequality.<\/p>\n<h1>Trauma and Crime Disparities in the U.S.<\/h1>\n<h2>Homicide Victimization (2023, U.S.)<\/h2>\n<ul>\n<li>Black people: 21.3 per 100,000<\/li>\n<li>White people: 3.2 per 100,000<\/li>\n<li>Black individuals faced homicide at <strong>more than 6 times the rate<\/strong> of White individuals (<a href=\"https:\/\/www.vox.com\/policy\/353878\/new-guns-us-violence?utm_source=chatgpt.com\">Vox<\/a>, <a href=\"https:\/\/bjs.ojp.gov\/document\/hvus23.pdf?utm_source=chatgpt.com\">BJS Report<\/a>).<\/li>\n<\/ul>\n<h2>Violent Crime Victimization (2017\u20132021, BJS)<\/h2>\n<ul>\n<li>Robbery rates: Black people (2.8 per 1,000), Hispanic (2.5), White (1.6)<\/li>\n<li>Overall violent victimization: White (~19.8), Black (~19.4), Hispanic (~18.4) per 1,000 (<a href=\"https:\/\/bjs.ojp.gov\/violent-victimization-race-or-hispanic-origin-2008-2021?utm_source=chatgpt.com\">BJS<\/a>).<\/li>\n<\/ul>\n<h2>Firearm Homicides<\/h2>\n<ul>\n<li>Black Americans are <strong>12 times as likely<\/strong> as White Americans to die by firearm homicide (<a href=\"https:\/\/www.usccr.gov\/news\/2024\/us-commission-civil-rights-releases-report-federal-efforts-examining-racial-and-ethnic?utm_source=chatgpt.com\">USCCR Report<\/a>).<\/li>\n<\/ul>\n<h2>Trauma Mortality Disparities<\/h2>\n<ul>\n<li>Studies show <strong>higher mortality rates<\/strong> for Black trauma patients vs White, even when controlling for injury severity (<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9133009\/?utm_source=chatgpt.com\">PMC Study<\/a>, <a href=\"https:\/\/journals.lww.com\/md-journal\/fulltext\/2018\/09280\/associations_of_race%2C_mechanism_of_injury%2C_and.97.aspx?utm_source=chatgpt.com\">LWW Journal<\/a>).<\/li>\n<li>African American patients were <strong>20% more likely to die in-hospital<\/strong> after trauma compared to White patients, with socioeconomic drivers like insurance status and neighborhood poverty as factors (<a href=\"https:\/\/journals.lww.com\/md-journal\/fulltext\/2018\/09280\/associations_of_race%2C_mechanism_of_injury%2C_and.97.aspx?utm_source=chatgpt.com\">LWW Journal<\/a>).<\/li>\n<li>Hospitals serving predominantly minority communities tend to have <strong>higher mortality rates<\/strong>, even when protocols are the same (<a href=\"https:\/\/en.wikipedia.org\/wiki\/Trauma_Quality_Improvement_Program?utm_source=chatgpt.com\">TQIP<\/a>).<\/li>\n<\/ul>\n<h2>Access to Trauma Care \u2014 \u201cMedical Deserts\u201d<\/h2>\n<ul>\n<li>In Los Angeles County, <strong>89% of Black-majority census tracts<\/strong> lack timely access to trauma centers, compared to much better access in wealthier, White neighborhoods (<a href=\"https:\/\/en.wikipedia.org\/wiki\/Medical_deserts_in_the_United_States?utm_source=chatgpt.com\">Medical Deserts<\/a>).<\/li>\n<\/ul>\n<h2>Bottom Line<\/h2>\n<p>\n    \u201cTrauma doesn\u2019t discriminate\u201d is a compassionate message for TV, but the data tells another story:\n  <\/p>\n<ul>\n<li>Black Americans face far higher rates of <strong>violent crime victimization<\/strong>, especially <strong>homicide<\/strong> and <strong>firearm-related death<\/strong>.<\/li>\n<li>They also experience <strong>worse trauma outcomes<\/strong>, driven by inequities in access to care, poverty, insurance gaps, and neighborhood disadvantage.<\/li>\n<\/ul>\n<p>I&#8217;m watching episode two of the <A HREF=\"https:\/\/www.imdb.com\/title\/tt13309330\/?ref_=ttep_ep_2\">Professor T tv show<\/a>. I love the show but I&#8217;m tired of the propaganda. The  episode claims that we have no idea of who might be a murderer. Anyone can turn into a murderer. There are no physical signs or genetic predispositions. It all comes down to social arrangements and policy. I suspect that there might be physical signs of dangerous people but you can&#8217;t get any funding to study this.<\/p>\n<p>ChatGPT says: You\u2019re noticing the tension between criminology-as-drama and criminology-as-science. TV crime fiction almost always leans toward \u201canyone could be a killer\u201d because it makes for better suspense and avoids accusations of profiling or determinism. But the reality is more complicated.<\/p>\n<p>There are, in fact, measurable risk factors.<\/p>\n<p>Genetic predispositions: Twin and adoption studies show a heritable component to antisocial behavior. Certain genes (like variations of MAOA, the so-called \u201cwarrior gene\u201d) correlate with higher aggression\u2014though always in interaction with environment.<\/p>\n<p>Neurological signs: Brain imaging finds consistent differences in people with violent histories: reduced activity in the prefrontal cortex (impulse control) and abnormal amygdala functioning (fear\/empathy). Traumatic brain injury is another big risk factor.<\/p>\n<p>Physiological markers: Low resting heart rate, poor autonomic response to stress, and hormonal imbalances (testosterone, cortisol) have all been linked to violent offending.<\/p>\n<p>Psychological\/behavioral traits: Psychopathy, impulsivity, and lack of empathy are strong predictors. These aren\u2019t hidden\u2014most extreme offenders display red flags early in life.<\/p>\n<p>What the show portrays\u2014\u201cmurderers are totally unpredictable\u201d\u2014is partly ideology. It reflects a social-constructivist frame that puts all weight on environment, upbringing, and policy. In real research, the consensus is \u201cgene\u2013environment interaction.\u201d Nature loads the gun, nurture pulls the trigger.<\/p>\n<p>You\u2019re also right that funding for biological markers of violence is limited. Ethical fears of \u201cbiological determinism,\u201d potential misuse for profiling, and political sensitivities all constrain research. It\u2019s safer for universities and funders to frame violence as social policy failure than to probe genetic or neurological predispositions.<\/p>\n<p> Television often insists that \u201canyone could be a murderer,\u201d but research from the past five years shows a more nuanced reality. Risk concentrates in a minority of people, and biology interacts with environment in ways that make some individuals more prone to violent behavior.\n    <\/p>\n<p>\n      Genetics plays a role, though never in isolation. The largest genome-wide studies, such as <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10902879\/\">Tielbeek et al. (2022)<\/a>, confirm that antisocial behavior is influenced by many small-effect genetic variants. Reviews like <a href=\"https:\/\/www.nature.com\/articles\/s41398-024-02870-7\">Koyama et al. (2024)<\/a> highlight how specific genes, including low-activity versions of <i>MAOA<\/i>, elevate aggression risk when combined with childhood maltreatment. In short, genes load the gun, but environment pulls the trigger.\n    <\/p>\n<p>\n      Brain science also shows consistent differences. A review by <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10044835\/\">Fritz et al. (2023)<\/a> found that people with histories of violence often have reduced prefrontal control and altered amygdala responses, affecting impulse control and empathy. A 2023 meta-analysis in <i>Nature Mental Health<\/i> reported structural abnormalities across antisocial personality disorder and psychopathy, showing that measurable brain differences are part of the picture.\n    <\/p>\n<p>\n      Physiology contributes as well. Low resting heart rate has long been associated with aggression, but a 2023 Mendelian-randomization study in <a href=\"https:\/\/www.nature.com\/articles\/s41598-023-37123-y\"><i>Scientific Reports<\/i><\/a> found no causal effect, suggesting correlation without causation. Hormonal factors such as testosterone show only small links to aggression, with <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31785281\/\">Geniole et al. (2020)<\/a> and <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10884082\/\">Lieberman et al. (2023)<\/a> finding limited effects. By contrast, traumatic brain injury is a stronger predictor. The <a href=\"https:\/\/www.thelancet.com\/article\/S1474-4422%2822%2900309-X\/fulltext\">Lancet Neurology Commission (2022)<\/a> and <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10456231\/\">Maresca et al. (2023)<\/a> show high rates of TBI among incarcerated populations, with clear links to aggression and violent offending.\n    <\/p>\n<p>\n      Psychological traits remain central. Tools measuring psychopathy and antisocial tendencies can predict recidivism with moderate accuracy. A <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37739584\/\">Lancet Psychiatry meta-analysis (2023)<\/a> reported that risk assessment instruments achieve performance well above chance, even if imperfect. Psychopathy in particular adds predictive power when assessing violent reoffending.\n    <\/p>\n<p>\n      What about facial scars and disfigurement? Contrary to popular belief, there is no evidence that such scars disproportionately mark murderers. Instead, studies like <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1745-9125.12143\">Johnson et al. (2017)<\/a> show that observers judge scarred defendants more harshly, which affects sentencing rather than actual crime rates. Population studies, such as <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9544440\/\">Amici et al. (2022)<\/a>, reveal that facial scars are common in the general population, making them unreliable as predictors. The illusion arises because trauma and violence\u2014which can leave scars\u2014are more common among incarcerated groups, but the scars themselves are not causal markers of homicide.\n    <\/p>\n<p>\n      The sharpest conclusion is that violent behavior is not random. It is shaped by clusters of factors: early conduct problems, psychopathic traits, prior violence, substance misuse, brain injuries, and certain gene\u2013environment interactions. These influences don\u2019t create destiny, but they do explain why risk is concentrated rather than evenly spread across the population. Television dramas simplify this into suspenseful unpredictability, but the science points to measurable\u2014if complex\u2014patterns.\n    <\/p>\n<p>The 2023 book <A HREF=\"https:\/\/www.amazon.com\/Paleoconservative-Anthology-Voices-Tradition-Political\/dp\/1666919721\">A Paleoconservative Anthology: New Voices for an Old Tradition<\/a> says:<\/p>\n<blockquote><p>\nThe progressive Left never tires of insisting that its view of human nature draws heavily from the social sciences. The logic of their argument runs roughly as follows: 1. Social science tells us that human beings are built for peaceful and selfless cooperation and that competition and conflict are functions of unhealthy, reactionary social orders. 2. Social science further informs us that all human beings are basically the same in their natural capabilities. If status hierarchy and inequalities arise, this has no relationship whatever to innate human differences. The human mind is a blank slate, receptive to whatever socialization and acculturation it undergoes, and so we can design the kind of social order we like depending entirely on how we socialize individuals and the cultural framework into which we place them. 3. For these reasons, unlimited social progress, by which is meant the promise of increasingly cooperative and egalitarian social order, is well within in our reach.<\/p><\/blockquote>\n<p>ChatGPT says: That summary is a sharp caricature rather than a fair restatement of how the mainstream social sciences actually think about human nature. Here\u2019s how it stacks up:<\/p>\n<p>1. \u201cHumans are built for peaceful, selfless cooperation.\u201d<br \/>\nNot quite. Evolutionary biology and anthropology consistently show humans are capable of both extreme cooperation and extreme violence. We evolved as highly social primates, but conflict and competition are just as deeply ingrained. Modern social science generally treats humans as dual-natured: we cooperate in-group, compete out-group, and context determines which side dominates.<\/p>\n<p>2. \u201cAll human beings are basically the same in natural capabilities; mind as blank slate.\u201d<br \/>\nThis is closer to how social science leaned in the mid-20th century, especially under the influence of cultural anthropology (e.g., Margaret Mead) and behaviorism. But the \u201cblank slate\u201d view has been under sustained attack for decades. Psychologists and geneticists now emphasize gene\u2013environment interaction. Differences in temperament, intelligence, aggression, etc., are partly heritable. Mainstream research today does not deny innate variation\u2014it insists variation is real but also shaped by environment.<\/p>\n<p>3. \u201cUnlimited social progress is within reach if we design the right social order.\u201d<br \/>\nThat\u2019s more ideological than scientific. Social scientists tend to be cautious about utopias. They do emphasize how institutions, incentives, and norms shape outcomes (crime, inequality, gender roles), but few argue that human nature is infinitely malleable. In fact, the reigning consensus in psychology, sociology, and economics is that human universals and constraints limit what policy can achieve. Social engineering can shift behavior, but not abolish hierarchy, competition, or status-seeking.<\/p>\n<p>So, bottom line: the anthology\u2019s passage captures a rhetorical style of the progressive left\u2014especially its more utopian branches\u2014but it distorts the mainstream of social science. The field no longer holds to a pure blank-slate model, nor does it claim humans are naturally peaceful. What it does hold is that social arrangements powerfully condition how human tendencies (both cooperative and competitive) play out.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>On this Netflix documentary series set in London trauma care centers, a nice asian lady doctor who suffered terribly says trauma does not discriminate. That&#8217;s not true. ChatGPT says: You\u2019re right that \u201ctrauma does not discriminate\u201d is more of a &hellip; <a href=\"https:\/\/lukeford.net\/blog\/?p=163514\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[29729],"tags":[],"class_list":["post-163514","post","type-post","status-publish","format-standard","hentry","category-medicine"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/163514","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=163514"}],"version-history":[{"count":13,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/163514\/revisions"}],"predecessor-version":[{"id":163530,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/163514\/revisions\/163530"}],"wp:attachment":[{"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=163514"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=163514"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lukeford.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=163514"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}