Adolescent boys in war-torn Colombia reflected the aggressive behavior they saw in their streets and homes, but some are also rejecting the masculine norms and aggression of their parents, according to research from the Brown School at Washington University in St. Louis.

Researchers reviewed transcripts of interviews with boys age 13-17 in two communities that housed many families that had been displaced by the violence between rebels, the government and paramilitary organizations at the end of 50 years of armed conflict. Peace accords were reached in 2016.

Boys told the interviewers they had experienced regular corporal punishment and witnessed other violence in their homes, usually during arguments about money in which men sought to exert dominance over women. Some boys said they sought refuge in the streets, but there, too, violent gangs ruled with threats of physical force.

Some boys mimicked their parents’ disciplinary style and saw violence as normal and the only way to retain respect on the streets. Others, however, took what they had seen as lessons and resolved to be different.

“There seemed to be an open-mindedness among these young boys, providing a potential pathway to interrupt the toxic masculinity and cycles of violence they had witnessed and experienced,” wrote Lindsay Stark, lead author and associate professor at the Brown School.

The paper was published August 6 in the Journal of Interpersonal Violence.

Restricting the sale of menthol cigarettes to tobacco specialty shops may reduce the number of retailers and increase the cost of smoking, according to new research from the Brown School at Washington University in St. Louis.

“Targeting the tobacco retail environment is rapidly emerging as the next frontier in tobacco control,” said Todd Combs, research assistant professor at the Brown School and lead author of the study “Modelling the Impact of Menthol Sales Restrictions and Retailer Density Reduction Policies: Insights From Tobacco Town Minnesota,” published Aug. 28 in the journal Tobacco Control.

“Policies focused on the places tobacco is sold can reduce tobacco use and tobacco-related health disparities by increasing the direct and indirect costs of tobacco to consumers,” Combs said.

Researchers used a computer model called Tobacco Town to test the effect of five retail restrictions on the reduction of retailer density; total cost per cigarette pack; and the average distance customers travel to buy cigarettes.

The model was based on data from six communities in Minnesota that are planning or have enacted menthol restrictions. During each simulated day in the model, computer-generated “people” smoke and make decisions on when and where to buy cigarettes.

Of those tested, the single policy with the largest impact on density reduction, especially in urban low-income areas, was restricting all cigarette sales to tobacco specialty shops. Restricting all cigarette sales or menthol cigarette sales in that way also may have the largest effect on the total direct and indirect costs of cigarettes.

In almost all of the simulations, low-income population and African Americans were the groups least impacted by policy changes, likely because they live in retailer-dense areas. That finding led the authors to suggest combining density restrictions and sales restrictions to reduce disparities.

“Communities often implement policies to reduce health disparities among priority populations,” Combs said. “Our results suggest that retail policies aimed at increasing direct and indirect costs of purchasing cigarettes and, presumably, reducing smoking among low-income or black or African-American populations might impact them less than for the overall population. This is likely because they live in retailer-dense areas (black or African-American smokers) or travel farther on average (lower income smokers) to purchase cheaper products.”

When Alice Emasu Seruyange, MSW ’10, first met L. Lewis Wall at WashU in 2009, she revealed her dream of building a fistula hospital in her home country of Uganda.

“It can be done,” Wall told her. But as a professor of sociocultural anthropology in Arts & Sciences and of obstetrics and gynecology at the School of Medicine, Wall warned Emasu that it would take about 10 years and $2 million to build.

“And, by golly, here we are,” Wall says. Today, Emasu is spearheading construction of the Specialized Women’s Hospital in Soroti, Eastern Region, Uganda. The hospital is owned by Emasu’s nonprofit, TERREWODE. Its official opening was Aug. 16, 2019, but the hospital began providing services in July.

This long-held dream of Emasu’s formed after a decades-long quest in Uganda to eliminate obstetric fistula, a hole that forms near the vagina after prolonged obstructed labor. The condition can result in long-term health issues and, in some cases, death.

Emasu first learned of the condition when she was 18 years old, after several of her girlfriends died. The residents of her home village of Bululu were not initially forthcoming about the cause of their deaths due to heavy stigmatization tied to the condition, but Emasu later discovered that they had died of obstetric fistula. “When I found out, I felt totally shattered, and I started asking questions,” Emasu says.

In 1999, Emasu founded The Association for the Rehabilitation and Re-orientation of Women for Development (TERREWODE), headquartered in Soroti. The nonprofit organization uses holistic methods for raising awareness of fistula, treating the condition and educating others to prevent it.

Meeting roadblocks while developing the nonprofit, Emasu chose to pursue her master’s degree in social work in the United States, a country she learned has very low fistula rates.

Her studies at WashU’s Brown School prepared her for the process of resources mobilization and building a hospital from scratch. At WashU, Emasu established relationships with both organizations and individuals who were instrumental to the evolution of the hospital.

Among her collaborators is Wall, who has visited Uganda several times since Emasu graduated to assist in the development of the hospital. “She has gradually emerged as the leading advocate for women with these injuries in Uganda,” Wall says.

Theresa Spitznagle, professor of physical therapy at WashU, is the vice chair of the Worldwide Fistula Fund, a nonprofit organization founded by Wall in 1995. The organization is providing a five-year budgeted grant to TERREWODE to stabilize the hospital’s operating budget.

“I can see her vision, and I can see her magnitude,” Spitznagle says. “Emasu is a charismatic woman who is asking the community what they want, and it’s driving her decision-making on what [the hospital is] producing.” Services will include treatment, surgical correction and rehabilitation of obstetric fistula.

“I am seeing what I dreamt over two decades ago becoming true with this hospital now being in place,” Emasu says.

The Center for Diabetes Translation Research is pleased to announce the 2019 Pilot and Feasibility Program grant recipients. The purpose of the Pilot and Feasibility Program is to foster innovate and transformative research designed to eliminate disparities in diabetes. Pilot grants provide initial research support to investigators exploring the feasibility of ideas or concepts related to the CDTR mission. Congratulations to the following three pilot recipients:

Abigail Barker, PhD
Research Assistant Professor, Brown School, Washington University in St. Louis 

Project Title: “The impact of sustained vs. temporary price changes for healthy and unhealthy foods: policy implications for low-income families”

Proscovia Nabunya, PhD
Research Assistant Professor, Brown School, Washington University in St. Louis

Project Title: “Food and dietary traditions, acculturation and associated health outcomes of new immigrants and refugees from Eastern Africa living in St. Louis”

Ellen Fitzsimmons-Craft, PhD
Assistant Professor of Psychiatry, Department of Psychiatry, Washington University School of Medicine in St. Louis

Project Title: “Developing and piloting a virtual reality experience to address childhood obesity”

To learn more about the CDTR pilots, visit the Pilot & Feasibility Program page.

People living in marginalized communities in St. Louis, particularly African Americans, have been enduring, as one study participant said, “real problems” such as violence and racism that are perceived as more immediate than issues of climate change, finds a study from the Brown School at Washington University in St. Louis.

“We suggest that threats like violence and racism play a significant role in shaping people’s awareness of, and engagement with, environmental issues,” said Joonmo Kang, a doctoral student at the Brown School and first author of the study, “’Let’s Talk About the Real Issue’: Localized Perceptions of Environment and Implications for Ecosocial Work Practice.” The study was recently published in the Journal of Community Practice.

“These imminent threats must be addressed alongside efforts to draw attention to environmental issues,” Kang said. “Despite this prioritization of violence and racism on the part of community residents, many of our participants applied an environmental justice lens to their experiences.”

While this finding echoes the history of violence and racism in St. Louis, Kang said, the study suggests that “this degree of alertness could serve as an opportunity in mobilizing in the face of these types of threats.”

Kang and co-authors Vanessa Fabbre and Christine Ekenga, both assistant professors at the Brown School, argue that ecological social work practice should incorporate localized perceptions of an environmental justice perspective in any education or community mobilization for environmental decision-making.

Stemming from calls to attend to localized perceptions of environmental issues, the study investigated how residents living in socio-economically challenged communities in St. Louis perceive and make meaning of their local environmental conditions, such as air, water and climate, and risks, especially with respect to their health and well-being.

The authors conducted interviews with residents on the north sides of both the City of St. Louis and St. Louis County.

“Participants’ perspectives reverberated the long history of racial inequality in St. Louis and demonstrated an awareness of environmental injustice and disproportionate health risks for African Americans,” Kang said. “Although they did not immediately see environmental issues like air pollution or climate change as having a direct impacts on their lives, they were sensitive to race-based environmental injustices.”

Particularly in places like St. Louis, where, Kang said, “racism informs the realities of people’s daily lives and the meanings people generate with respect to environmental issues,” social workers who are “knowledgeable about racism and environmental justice are well-positioned to carry out ecosocial work practice,” he said.

Our Global Programs Office recently responded to the currently political climate that is causing tension among the United States and so many others across the globe. Below is a statement from Carolyn Lesorogol, Professor and Associate Dean for Global Programs and Strategy, and Tammy Orahood, Director of Global Programs. 

Recently, Chancellor Andrew D. Martin posted a statement, which affirms and celebrates the international community at Washington University in St. Louis. We support the Chancellor’s sentiments regarding the centrality of students, staff and faculty from around the world who contribute in myriad ways to the success of the university’s mission. As tensions rise between the United States government and so many across the globe, it is more important than ever to remain steadfast in our commitment to being a welcoming place for people from across the world, nation and our local community.

The plight of asylum seekers and immigrants at the U.S. southern border who are fleeing violence and hardship in their home countries and are often being met with inhumane treatment is one stark example of unacceptable policies that violate ethical principles of social justice and humanitarian concern foundational to our professions. Furthermore, geopolitical tensions over numerous issues create potentially challenging situations for members of the Brown School community from these countries, as well as for our university partners around the world.

In the face of these ongoing challenges, the Brown School is and will remain proud to be the St. Louis home to international students, staff and faculty who enhance our community through their ideas, experiences and perspectives. They help ensure that our research and educational offerings are relevant, innovative and impactful locally and globally. Any barrier to recruiting the very best faculty, staff and students from across the world threatens our ability to fulfill the mission of our school, the pursuit of research and educational excellence for the purpose of advancing justice and change.

Policy decisions suggest that our policy and advocacy skills, at the local, state and federal level are critical. We must ensure that everyone in our community feels safe, and that we each take appropriate actions toward the goal of a just social contract for all people in the U.S. and across the globe.

At the Brown School, we are committed to actions that advance equity and bring about positive social change. There are a myriad of ways for all of us to be active, including the following: 

1. Educate yourself regarding current policies and newly emerging executive orders or legislation. Our stakeholders and communities depend on us to understand emerging policy decisions. We should make serious efforts to discern who will be affected and how, as well as identify opportunities to dissent and spur action to protect those made vulnerable by new policy actions.

2. Participate in action-oriented groups of your choice; help to craft a high impact action agenda.

3. Contact elected officials to share your individual position on local, state and federal policy issues.

4. Identify local and national organizations in which you can contribute your talents. For example, the Refugee and Immigration Center for Education and Legal Services in Texas (RAICES) has been instrumental in supporting separated and detained families at the border and others who are seeking asylum in the United States: https://www.raicestexas.org/

5. Help create an inclusive community by checking in with and showing support to our international students, staff, and faculty colleagues who might be distressed or concerned. 

Students who are feeling upset can find support by talking to Danielle Bristow, Assistant Dean for Academic Affairs, Tammy Orahood, Director of Global Programs, Linyun Fu, Manager of Global Programs or Carolyn Lesorogol, Associate Dean for Global Strategy and Programs.

We are a diverse and inclusive community that values all of our members!