"Invisibility is a lack of hope, a lack of opportunity, and the inability to access the basic elements that define a safe, productive life, including education, health care, housing, food, clean water, sanitation, and security." - Invisible Children
Demographics of Invisibility
While stress can take many forms, including some stresses that are in fact positive and can facilitate a child’s normal development, toxic stress – defined as “prolonged activation of stress response systems in the absence of protective relationships, usually from strong, frequent and/or prolonged adversity”[i] – can weaken developing brains. Frequent or continual stress on young children lacking adequate protection mechanisms and support from adults increases the risks of lifelong health and social problems.[ii]
Constant serious adversities can overwhelm a child’s tendency toward resilience, and negative behaviors can ensue as young people struggle to cope with the negative circumstances of their lives. Self-destructive behaviors can result, with addiction to various substances or behaviors too common.
Bad behaviors are interrelated - despair can lead to substance abuse, which in turn can lead to risky sexual behavior, violence, or suicide. Separating cause and effect within these behaviors is inexact, even though evidence exists to suggest that the incidence of self-destructive actions among young people in low-income societies is considerable.[iii] But it is clear that the use of toxic substances among the poorest of the poor contributes to cycles of despair.
While tobacco consumption in the United States has continued to decline over the past decade, tobacco production has never been higher, with products exported vigorously to the developing world. Exported with the products are the considerable negative health impacts of tobacco use.
Over the next 25 years the number of smokers globally is projected to increase 45 per cent, from 1.1 billion to more than 1.6 billion.[iv] Every day between 82,000 and 99,000 young people begin smoking, most of whom are in low or middle-income countries. Some are younger than ten.[v] The impact of their new habit is graphic. In the lowest-income families, scarce resources are often used to support the addiction rather than food, thereby making tobacco a contributing factor to hunger and malnutrition.[vi] Poverty is accentuated and perpetuated when tobacco related illnesses disable or claim the lives of primary breadwinners.[vii]
Alcohol consumption among young people has risen steadily. In 2011, 71 of 73 countries participating in the World Health Organization’s survey of alcohol usage reported increased consumption among those younger than 18. The highest rates of consumption were in economically fragile countries, including Uganda, Zambia and Namibia. Also, the countries of the former Yugoslavia, beset by the social and economic residue of years of conflict, showed high usage as well.[viii] In these countries, heavy alcohol consumption has been linked to suicide, especially among the young.[ix]
Similarly, drug use has expanded rapidly and is now concentrated among those under the age of 25.[x] Because drugs cost money, young people in need often resort to acquisitive crimes such as petty robbery, shoplifting and thieving to procure their drugs, leading to higher crime rates in areas of high usage. The cost of drug-related acquisitive crimes in the U.K. approximated £13.9 billion, or $23.4 billion, in 2004.[xi] This, of course, does not factor in the human costs. And survey after survey has confirmed that drug use is much more rampant in areas with high inequalities in income distribution and high unemployment, particularly among those under 25.[xii]
Drug use in the United States continues to exact a steep financial and personal toll. According to a study by the Center on Addiction and Substance Abuse (CASA) at Columbia University, 46 per cent of all high school students currently use addictive substances, and 12 per cent meet the clinical criteria for addiction.[xiii] The immediate costs per year of teen use include an estimated $68 billion associated with underage drinking and $14.4 billion in substance-related juvenile justice programs.[xiv]
The emergence of crystal methamphetamine as a drug of choice for young people has affected both rural and urban communities, but young people between age 18 and 25 in the smallest rural areas use meth at a rate that is nearly twice the rate of young urban adults (2.9 per cent vs. 1.5 per cent).[xv] In Idaho, a largely rural state, of more than of 2,000 female offenders with a substance abuse problem, over 80 per cent claim meth as their drug of choice. This small state spends approximately $66 million per year housing adult male inmates who admit to having a meth problem. California’s Department of Alcohol and Drug Program echoes Idaho’s problems. Meth is now the most commonly reported drug problem in the state, surpassing alcohol.[xvi]
Other drugs have left their mark as well. Heroin use claimed more than 3,000 lives in the US in 2010, 88 per cent of whom were white and more than 20 per cent under the age of 24. Heroin deaths of teenagers and young adults tripled during the 2000s. Abuse of painkillers, including OxyContin, claimed even more lives, nearly 16,000 in 2010.[xvii]
In the horn of Africa and the Arabian Peninsula, people have been chewing khat[xviii], grown in the highlands, for thousands of years. In Yemen, up to 90 per cent of men and 50 per cent of women chew khat three to four hours a day, and as many as one-fifth of all children under 12 chew khat daily. Khat imparts euphoria, followed by depression. Regular chewing can lead to sleepiness and low productivity. Chewing is a social act in many communities, and a refusal to chew can lead to ostracism. Families sometimes deprive their children of essential foods so that they can spend their limited income on khat.[xix] Jamal Al-Shammi, head of a Yemeni nongovernmental organization (NGO) known as the Democratic School, identifies impacts of khat that go beyond the consumer’s body. “Khat chewing . . . . . breaks down immediate family ties. Men chew alone, women chew alone and children are eventually left alone to do as they please with no adult supervision.” [xx]
Among children in poverty around the world, glue-sniffing provides a cheap high to help them forget their daily despair. Throughout Central and South America, street-connected children and the extremely marginalized turn to toxic inhalants, including glue, gasoline, lighter fluid, propane and kerosene. In Kenya, thousands of street-connected kids sniff glue, most often sold to them by women drug dealers in Nairobi, many of whom are mothers trying to earn a living for their own children.[xxi] Glue costs very little, is readily available, and the high lasts for hours. But the high also carries with it the risk of respiratory failure, brain damage and death.[xxii]
[iv] Mackay J, Eriksen M, Shafey O. The Tobacco Atlas. 2nd edition. Atlanta, GA: American Cancer Society; 2006.
[v] Mackay J, Eriksen M, Shafey O. The Tobacco Atlas
[vi] Lando, Harry et al, 2010. “Tobacco is a Global Pediatric Concern” Bulletin of the World Health Organization 2010, 88:2-2.
[vii] Efroymson D, Hammond R. Tobacco and Poverty: A Vicious Circle. Geneva: World Health Organization; 2004
[viii] http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf, p.10.
[ix] http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf, p.22.
[x] http://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_web_small.pdf, p.4.
[xi] http://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_web_small.pdf, p.71.
[xii] http://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_web_small.pdf, p.88.
[xv] “Substance Abuse Among Rural Youth: A Little Meth and a Lot of Booze “, Maine Rural Health Research Center, Muskie School of Public Service Research and Policy Brief, 2007.
[xvii] Ben Garvin, “Heroin’s Small Town Toll, and a Mother’s Pain” New York Times, February 11, 2014; http://www.nytimes.com/2014/02/11/us/heroins-small-town-toll-and-a-mothers-pain.html
[xviii] Khat (Catha edulis ) is a flowering plant that is native to the Horn of Africa and the Arabian Peninsula. It contains a monoamine alkaloid called cathinone, an amphetamine-like stimulant, which is said to cause excitement, loss of appetite, and euphoria.
[xix] Bulletin of the World Health Organization, Volume 86, Number 10, October 2008, 737-816.
[xx] Bulletin of the World Health Organization, Volume 86, Number 10, October 2008, 737-816.
[xxi] Anders Kelto, “Nairobi Glue Pusher Preys on Addicted Kids to Help her Own,” Public Radio International, PRI’s The World, 2012-10-29.
[xxii] “Adolescent Inhalant Use and Selected Respiratory Conditions”, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services, 2010.