Shot in the US: gun culture, urban violence and survival | Bindu Kalesan | TEDxBeaconStreetSalon
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0:12 - 0:15Think of a 12-year-old, white, little girl
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0:15 - 0:20living in safe suburbia
with her parents and an older brother. -
0:21 - 0:24She's playing in her parents' bedroom,
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0:24 - 0:28and she finds a gun
in her father's nightstand. -
0:28 - 0:29She's so excited.
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0:29 - 0:32She runs down to her brother
and shows him the gun. -
0:32 - 0:34They're both very, very thrilled.
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0:35 - 0:41One day, her mom decides
to go for shopping with her aunt, -
0:41 - 0:44and every time she went shopping,
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0:44 - 0:47they got a little treat,
McDonald's Happy Meal. -
0:47 - 0:48So, she and her brother
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0:48 - 0:51are sitting together
and eating their food, -
0:51 - 0:53and her brother wanted her fries.
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0:54 - 0:57She decided, "No,
I am not giving you the fries." -
0:58 - 1:02He got so angry and he ran up the stairs.
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1:02 - 1:06At that instance,
she knew he was going for the gun. -
1:06 - 1:08She runs behind him,
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1:08 - 1:13and at the top of the stairs,
she sees him with a gun pointed at her. -
1:14 - 1:17Then she heard a bang and she fell back.
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1:17 - 1:19Her brother shot her in her face.
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1:19 - 1:22Life changed for her after that.
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1:22 - 1:24And this is a real story.
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1:24 - 1:30These are the stories of trauma
that you hear day in and day out. -
1:30 - 1:32But now,
-
1:32 - 1:36let's think that this is
not a little, white girl -
1:36 - 1:38but a 12-year-old boy.
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1:39 - 1:42He's coming back from school
into a neighborhood -
1:42 - 1:44which is rife with crime,
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1:44 - 1:46and he gets shot in his back.
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1:47 - 1:51The story was not even mentioned
in the newspapers. -
1:52 - 1:55This happens more often
than the earlier story. -
1:56 - 2:00America makes up about 5%
of the world's population -
2:00 - 2:05but also has 42% of civilian guns.
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2:05 - 2:09Now we're at a time
where there are more guns than people. -
2:09 - 2:14The constellation of NRA lobbying power,
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2:14 - 2:20gun culture, easy availability of guns,
and the Second Amendment together -
2:20 - 2:25has resulted in high numbers
of deaths and injuries due to guns, -
2:25 - 2:29and this directly violates
basic human rights. -
2:30 - 2:34James Madison proposed
the Second Amendment -
2:34 - 2:38as a compromise between Federalists
and Anti-Federalists, -
2:38 - 2:40but now we are at a point
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2:40 - 2:44where there are more guns
than people in the country. -
2:45 - 2:48Given that, we have to also
take a step back -
2:48 - 2:51and look at the history of guns.
-
2:52 - 2:58Guns and America were born together,
and then they grew up together. -
2:59 - 3:03Guns, then, were used to enslave people
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3:04 - 3:09and also to take land from the natives,
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3:10 - 3:15though we have to keep in mind
those basic human rights violation -
3:15 - 3:17right from the get-go.
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3:18 - 3:20In modern America,
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3:21 - 3:26most of the gun owners
say that they own guns for protection; -
3:26 - 3:32however, national crime rates
have been declining since 1993 - -
3:32 - 3:35we are at an all-time low.
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3:35 - 3:36America's safe.
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3:36 - 3:38I'm from India.
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3:39 - 3:42Now, for the protection
of the guns, right? -
3:42 - 3:44So guns protect.
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3:44 - 3:48On the other hand, is it risky?
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3:49 - 3:53Most often people say
that "Oh, we still don't know," -
3:53 - 3:55but that's untrue.
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3:55 - 3:58We've known it from 1986,
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3:58 - 4:03when Dr. Kellermann first reported
in New England Journal of Medicine, -
4:03 - 4:06for every self-protection gun event,
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4:06 - 4:10there will be 1.3 accidental deaths,
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4:10 - 4:154.6 criminal homicides, and 37 suicides.
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4:16 - 4:20In Boston, there are
at least one shooting in a day. -
4:20 - 4:25Nationally, more than 100
Americans are shot dead, -
4:25 - 4:30and another 220 to 280 will be shot,
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4:30 - 4:35but they are treated in emergency rooms
across the country and they survive. -
4:35 - 4:39So seven out of ten
who are shot will survive. -
4:39 - 4:45As a result, we have at least 1 million
gun violence survivors amongst us. -
4:45 - 4:49And the annual cost
of treating such injuries -
4:49 - 4:52amount to around 18 billion dollars.
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4:52 - 4:57We've heard a lot about mass shootings
and school shootings, -
4:57 - 5:01but in reality, that's only
the tip of the iceberg. -
5:01 - 5:04It's 2% of the annual deaths.
-
5:04 - 5:10In fact, there is about 40,000 people
or more die every year. -
5:10 - 5:14That's about 30% -
they're shot, they die right away. -
5:14 - 5:19And another 30% are taken into the ER,
they have very low injury severity, -
5:19 - 5:22and therefore, they're
patched up and sent home. -
5:22 - 5:26Another 40% have very severe
injuries from the ER; -
5:26 - 5:28they're hospitalized.
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5:28 - 5:35As for the non-fatal gun injuries,
we have about 85,000 to 100,000 per year. -
5:35 - 5:39There are five different types,
or intents, of injury: -
5:39 - 5:41The red band is the assault.
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5:42 - 5:44And the blue band is unintentional.
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5:44 - 5:46Green is suicide.
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5:47 - 5:48Yellow is undetermined.
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5:48 - 5:51And finally, legal intervention,
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5:51 - 5:55where a civilian is shot
by an officer of the law. -
5:56 - 5:59Those people who survive gun injuries
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5:59 - 6:04are largely because of assault injuries
as well as unintentional injuries. -
6:04 - 6:0988% of those who use a gun
for suicides will die. -
6:10 - 6:15We also found that the severity
of gun injuries are also rising with time, -
6:15 - 6:19and that indicates that guns
have become better, -
6:19 - 6:21bullets are becoming better,
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6:21 - 6:23therefore more lethal.
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6:23 - 6:26But our healthcare is also improving.
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6:26 - 6:29With regards to gun violence survivorship,
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6:29 - 6:31it's a nonentity
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6:31 - 6:36because people think about gun violence
as something very dramatic, -
6:36 - 6:40something like a mass shooting,
something like a school shooting, -
6:40 - 6:46but in fact, most of the victims
are those who survive this gun violence, -
6:46 - 6:52and they are poor folks
who live in impoverished neighborhoods. -
6:52 - 6:56They usually have Medicare
or no insurance at all. -
6:57 - 6:59And gun violence survivors
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6:59 - 7:03doesn't mean that "OK,
we are treated in the hospital. -
7:03 - 7:04We're all good.
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7:04 - 7:05We're going back to our lives."
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7:05 - 7:07They never return back to their lives.
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7:07 - 7:12Their lives are blighted by addiction,
hospitalizations, pain, -
7:12 - 7:17neurological complications, disability,
and even early death. -
7:17 - 7:22Overall, surviving gun violence
is very, very expensive. -
7:22 - 7:28We studied the impact
of gun suicides in rural counties, -
7:28 - 7:32and we found that those rural counties
with high gun suicides -
7:32 - 7:35also had opioid death rates
which are high, -
7:35 - 7:37high opioid prescription rates,
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7:37 - 7:41high veteran population,
and also high crime rates. -
7:41 - 7:46These counties were
also adjacent to urban counties, -
7:46 - 7:50which explains easy availability
of guns and drugs. -
7:50 - 7:55So we concluded that
the opioid epidemic and gun suicides -
7:55 - 8:00co-occur in rural populations
as diseases of despair. -
8:00 - 8:04We also studied survivors of gun suicide
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8:04 - 8:08and looked at their clinical descriptions,
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8:08 - 8:11and we found three distinct phenotypes.
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8:11 - 8:17The largest group had depression,
hypertension, blood loss anemia, -
8:17 - 8:19they smoked and they drank alcohol.
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8:20 - 8:26The second group was mainly children,
pregnant women, and new mothers. -
8:27 - 8:31Third group were all depressed
and had fewer injuries. -
8:32 - 8:35We also studied the impact
of having mental illness -
8:35 - 8:38when a person is shot.
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8:38 - 8:42We compared people with mental illness
versus people without mental illness, -
8:42 - 8:46and we found that the risk of drug use
during the first year -
8:46 - 8:50is about twice as much
in people with mental illness -
8:50 - 8:53as compared to people
without mental illness, -
8:53 - 8:57and that risk shot up to 3.5
in the third year. -
8:57 - 9:02There is also racial discrimination.
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9:02 - 9:05Gun violence does discriminate.
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9:05 - 9:07It discriminates
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9:07 - 9:11because most of the gun violence
occur in poor communities. -
9:11 - 9:13And we are easy.
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9:13 - 9:17We feel almost a need
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9:17 - 9:23to be able to associate a white person
who survives gun violence as a hero -
9:23 - 9:28whereas, quickly, a black person
from a poor community -
9:28 - 9:30is seen as a criminal.
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9:31 - 9:36That happens not just, you know,
when they are treated, -
9:36 - 9:41but it also happens in terms
of how they are presented in the media. -
9:42 - 9:45Primarily, suicide victims are white men,
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9:45 - 9:51and assault victims are black men
who are below 25 years. -
9:51 - 9:56So they don't have
the luxury to get cancer. -
9:56 - 10:00They do not have the luxury
to get chronic diseases. -
10:00 - 10:05And even before that,
they'd have been injured and traumatized. -
10:06 - 10:08It is very easy for us to think
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10:08 - 10:13that gun violence happening
in a community is their fault, -
10:13 - 10:15but that's not it.
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10:15 - 10:16It is poverty.
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10:16 - 10:19The root cause of gun violence is poverty.
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10:20 - 10:21Poverty leads to crime.
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10:21 - 10:26Crime leads to violence exposures,
leading to mental illness, -
10:26 - 10:29and then keeps that cycle going,
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10:29 - 10:32making the poor poorer.
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10:32 - 10:34That's what gun violence does.
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10:34 - 10:40There is another discriminatory term,
"trauma recidivism," used in medical care. -
10:40 - 10:47So in 1990, Dr. Reiner decided, "Hey,
let me talk about trauma recidivism." -
10:47 - 10:51These are hospitalized trauma patients
with a known history of trauma. -
10:51 - 10:55He intended it not to be discriminatory,
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10:55 - 10:58but in the end, he was
extremely discriminatory, -
10:58 - 10:59and it stuck.
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11:00 - 11:05There are about 78 different papers
on trauma recidivism -
11:05 - 11:12implying that every victim
is a perpetrator, is a criminal. -
11:12 - 11:17The first time I heard about this term
was from a survivor. -
11:17 - 11:23He was refusing to go back to his doctor -
and he was shot the second time. -
11:23 - 11:25He was a janitor in a school.
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11:25 - 11:26And he told me,
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11:26 - 11:28"I'm not going back to that doctor.
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11:29 - 11:31He called me a criminal."
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11:31 - 11:34And I told him, "Doctors
don't call people criminals." -
11:34 - 11:37He said, "He called me a recidivist.
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11:37 - 11:40I looked it up. I know what that means."
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11:41 - 11:45So we have to be careful
in using such terms. -
11:46 - 11:50Then there is this fantastical
culture of gun violence, -
11:50 - 11:53the heroic depiction of having a gun,
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11:53 - 11:56where we can shoot ourselves
out of a situation. -
11:56 - 11:58And it's rampant,
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11:58 - 12:01but it's rampant in certain population.
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12:01 - 12:03There are pockets of gun culture,
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12:03 - 12:04the strong gun culture
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12:04 - 12:09rooted in this country
for the reasons I mentioned before. -
12:09 - 12:14But the real effects are in cultures
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12:14 - 12:20or in communities which are poor,
where people of color live. -
12:20 - 12:24It causes mental illness,
and it causes poverty. -
12:24 - 12:29It makes sure that the poor
remains poor or even poorer. -
12:29 - 12:34They never have the chance
to move to resiliency. -
12:34 - 12:41They live in high stress all the time,
traumatic exposures all the time. -
12:41 - 12:46Imagine if you have to listen to gunshots
every day in your life. -
12:46 - 12:50You're not in a war zone,
but that is how Roxbury is. -
12:51 - 12:56We know guns are
the dark underbelly of America. -
12:57 - 13:03It helped to enslave people,
it helped to steal lands - -
13:03 - 13:05that violent history.
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13:05 - 13:09Then we also know that
violent-crime rates are on the decline. -
13:10 - 13:13We know the risk of guns
outweigh the benefits. -
13:13 - 13:15And we know that gun violence
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13:15 - 13:20affects and marginalizes
poor communities of color. -
13:20 - 13:23At this point, we've got
to really ask ourselves, -
13:24 - 13:29"Is it really the fear of victimization
that's causing you to own guns, -
13:29 - 13:32or is it just that you want
to be a Viking?" -
13:32 - 13:34The question is also,
-
13:34 - 13:38"Given that we know all these,
are there solutions?" -
13:38 - 13:40Yes, there is a solution.
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13:40 - 13:44Until now, NRA and the gun manufacturers
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13:44 - 13:47have made a lot of money
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13:47 - 13:51killing people and decimating
different populations, -
13:51 - 13:57but they have never taken ownership
of gun debts and gun violence. -
13:57 - 13:59It's time to change that.
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14:00 - 14:01We need policies.
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14:01 - 14:05I'm not talking about the 99
different restrictive gun policies -
14:05 - 14:11but policies which will change
the communities that guns have decimated: -
14:11 - 14:15provide them with lifetime health care,
financial assistance -
14:15 - 14:18regardless of this victim status
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14:18 - 14:22or regardless of whether they are
perpetrating a crime -
14:22 - 14:25because a bullet through
a human body is the same, -
14:25 - 14:29regardless of whether you are
a victim or a criminal. -
14:30 - 14:35Mental health services,
one of the main results of gun violence - -
14:35 - 14:36and we've realized
-
14:36 - 14:39that the opioid epidemic is really fueled
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14:39 - 14:42because of a mental
health crisis that we have. -
14:42 - 14:45And of course, self-servingly,
-
14:45 - 14:47we need research funding dollars
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14:47 - 14:51to study gun violence
survivorship as a disease, -
14:51 - 14:53not as a political problem.
-
14:54 - 14:57We have to come together
as a medical community -
14:57 - 15:00and actually allocate dollars
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15:00 - 15:02so that we can study this
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15:02 - 15:08and make sure our communities,
which are suffering, will heal. -
15:08 - 15:10Thank you.
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15:10 - 15:11(Applause)
- Title:
- Shot in the US: gun culture, urban violence and survival | Bindu Kalesan | TEDxBeaconStreetSalon
- Description:
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Gun culture is written into the American Constitution, and the two grew side-by-side. Every day, gun violence results in over 1 million surviving victims across the country. Their lives are blighted by mental illness, hospitalizations, addiction and other diseases, treating the bullet wound, but not curing the underlying problem. Despite everything that emergency rooms can do, they return to neglect and poverty, drowning in a culture of violence.
Dr. Kalesan is a clinical epidemiologist and data scientist, with three interdisciplinary research pillars, within the umbrella of eliminating racial disparities and discrimination and promoting equity and social justice: 1) trauma and violence (firearm injury epidemiology), 2) cardiometabolic diseases 3) psychiatric and mental health conditions. She uses novel statistical methodology, supervised and unsupervised machine learning and emerging m-health technologies. Her most recent study in the Journal of Affective Disorders found that the average profile of an American using a gun for suicide is a married, white male over the age of 50 who is experiencing deteriorating health.This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 15:16