“You know, life just isn’t what I thought it was going to be. Too many bad things have happened and, well, it’s just not worth it anymore.” John, 57 years, sighed as he spoke with his son over the phone. “I just wanted to spend this last moment with you . . . thank you for being my son.” Confused, Jesse, 29 years, heard some shuffling and before he could ask the meaning of his father’s words, the sound of gunshot blasted through the phone speaker. Jesse dropped the phone and screamed; his father had just committed suicide.
Jesse’s life had never been easy, although parts of it could be considered typical for a rural American scene. He grew up in low-socioeconomic conditions, as did most of the residents in the small town, population 2000, in the middle of Montana. The community lacked access to many basic resources, and the single school system was ranked one of the lowest in the state. In addition, consuming drugs and alcohol became second nature, falling under the umbrella of entertainment, which began in adolescence and slowly moved from use to abuse. The town seemed to tie people to a dissolute destiny; most people met with invisible resistance as they tried to find success outside the town.
All these aspects contributed to Jesse’s life outcomes. But, despite all that, the year following his father’s death was the most difficult year of Jesse’s life. He dealt with his father’s upcoming death anniversary by following in his father’s footsteps: overdosing on drugs and taking his own life. In less than one year, two men from the same rural community chose to face their problems with suicide.
These two deaths are just part of the suicide epidemic taking place right now, and they highlight suicide in Montana, whose rates are the worst per capita in the nation.1 Approximately 29 people per 100 000 are at risk for dying of suicide in Montana. Most of the population lives in rural settings (risk of suicide is 1.8 times more likely in rural areas),2 Montana ranks among the highest states for health professional shortage,3 it has the highest prevalence of alcohol use and binge drinking,4 and it has a robust gun culture. Montana’s setting is “ideal” for suicide.
Currently, suicide prevention in Montana focuses on population approaches, primary prevention, surveillance and data, and multidisciplinary collaborations.5 These strategies are obviously not working. Maybe it is time to add another dimension to suicide prevention—a focus on a person’s internal ability to endure, to move beyond the difficulties, to thrive despite life’s challenges—the personality feature “resilience.” Many researchers have proposed tangible methods to build resilience, but never with the aim of addressing suicide.6–10
Strategies could be employed in a classroom, as schools act as change agents and are ideal for promoting children’s cognitive, affective, and behavioral skills, and teachers can play a supportive role and reinforce competencies.11–23 For example, the PAX Good Behavior Game is an environmental intervention currently employed in 47 Montana schools that is used to increase attentiveness, decrease aggressive behavior, improve academic achievement, and bring awareness to mental health and substance abuse.24 This type of program could integrate aspects of Promoting Alternative Thinking Strategies, which is a positive youth development curriculum designed to encourage self-control and emotional understanding and build self-esteem, relationship skills, and interpersonal problem-solving skills—traits of resilience.11,25 This comprehensive program could have great outcomes in the Montana population. Ultimately, resilience is a lifelong strategy that can exist when other solutions fall by the wayside because of location, time, place, and lack of resources—and resilience might have saved the lives of both Jesse and his father.
8 Years Ago
Mexicans as Threats to US Public Health
Negative representations of Mexicans as diseases carriers and health burdens shaped the programs, policies, and practices of immigration and health agencies. Many documented cases illustrate the medicalization of the Mexican immigrant historically. The reaction to typhus outbreaks in the early 20th century and the development of health policy standards . . . revolved around representations of Mexicans as a threat to public health. Race served as an interpretive framework for explaining the typhus outbreaks and for developing a double-screening policy . . . and thus precluded any need to ameliorate the living conditions of workers once they had settled in the United States. Such reasoning firmly established obviated the need for a deeper investigation into the systemic inequality that fostered the inferior health and living conditions of Mexican laborers.
From AJPH, June 2011, p. 1030
16 Years Ago
The Health Status of Foreign-Born Black Men
Our study demonstrated that foreign-born Black men report substantially better health than do US-born Black men and that their health status is similar to or slightly better than that of US-born White men across a number of health behaviors and health measures, including overall health status. . . . Compared with White men born in the Northeast, Black men from the Caribbean had about a 25% lower rate of death from cardiovascular disease and a 50% lower rate of death from coronary disease but higher rates of death from stroke and hypertension. . . . As the foreign-born Black population in the United States continues to grow, it will become increasingly important to understand how foreign-born Blacks contribute to the health of the overall Black population and whether their short-term health advantages remain over the long term.
From AJPH, October 2003, pp. 1743–1746 passim
Biography
