University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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Gangs and Violence

Gang life. It's full of contradictions, attractions that explain why people still join gangs and risks that are well-known to everyone. Gangs can give you a sense of identity and belonging, but can also give you a whole world of enemies overnight, from members of other gangs to police and even to your own friends and family who don't want you in a gang. Gang members can be loyal to each other and feel like family, but can also get you in over your head with dangerous activities like using or dealing drugs, stealing cars, fights and shootings. Being in a gang can make you feel like you have protection in your own neighborhood, but you're not protected from other gangs who want to strike back with drive-bys or other attacks. There may not be a lot of good job opportunities in your neighborhood, but it's hardly an "opportunity" if gang involvement gets you hurt or leads to being arrested. You can get rich from gang activities like selling drugs or pulling robberies, but that money is no good to you if you land in jail as a juvenile or adult. Getting tattoos and wearing colors can let everyone know who you are and where you stand, but can also end a job interview when they notice your ink, or get you hurt or killed if you're in the wrong place at the wrong time. Gang membership can make you feel like you're a man who stands strong, but it can also put you in a wheelchair for the rest of your life if a beating, stabbing or shooting leaves you with a spinal cord injury.

Of course, not everyone who joins a gang is injured, and not everyone who joins a gang goes to jail. But a spinal cord injury really could happen, and does happen, to real people who live the gang lifestyle. Six participants in our study, or 30% of the total number who took part, were involved with gangs, and five of them received their spinal cord injuries in shootings that were gang-related. (The sixth gang member was injured in a high-speed car chase, trying to escape the police after he got drunk and stole a car.) And one of them was later killed in street violence related to drug-dealing.

Gangs obviously have a very strong pull for people in them. If someone with a spinal cord injury is still a gang member, then telling them that gangbanging could injure their skin and cause a pressure ulcer (which means the same thing as "pressure sore" or "bedsore") isn't exactly going to be a strong enough reason for them to quit. But it is one more way that being in a gang can cause pain. What we want to do is offer some facts, and some alternatives for people with spinal cord injury who are still involved with gangs.

Some gang members find safety in numbers. They protect their homeboys, and their homeboys protect them, from rival gangs and other threats. If a crime is committed, gang members get away fast and count on the witnesses not being able to identify them (or not being willing to oppose the gang). But a person with a spinal cord injury can't get away with the same risks other people do. While there are many activities that people with a spinal cord injury can take part in and do very well, the truth is that a person with spinal cord injury has more risks to their health than the nondisabled, including being more likely to develop some kind of illness or medical complication, requiring more specialized or complicated health care 1. Getting into even a shoving match, needless to say a fight, is enough to injure skin, which can cause a pressure ulcer, or could cause autonomic dysreflexia, a reaction of the body to a strong irritation that can damage eyesight or even cause a stroke. If there's a situation calling for a quick getaway, well, just imagine what will happen. Also imagine how easy it would be to spot, and positively identify, "that guy in the wheelchair."

And a person with a spinal cord injury definitely doesn't want to go to jail. Four of the people who participated in our study spent some time in jail after their injuries (not necessarily because of gang activities). Among the risks for a person with spinal cord injury is that a person will be hurt by violence behind bars; one study participant said that they had a pressure ulcer that was made much worse when they were mistreated. Another risk in jail is not getting proper medical treatment; one study participant got a pressure ulcer that became infected and needed surgery, all because the prison infirmary (that is, clinic) discharged them too early. One of our study participants got a pressure ulcer when the padding on a brace wore out and wasn't replaced. And a study participant got a pressure ulcer in prison when, due to overcrowding, they were one of many inmates forced to sleep on mats on a concrete floor, a condition that happens even in county jails 2. (For more about the situations people with spinal cord injury face in prison, check the section of this publication about "Living Situations Other Than a Private Home".)

Want more facts on how risky it is to have a violent lifestyle? Statistics show that since the year 2000, 11.2% of all spinal cord injuries have been caused by violence 3, but that almost 50% of all spinal cord injuries that happen to people in urban communities are caused by violence 4. In a 2001 study of spinal cord injuries caused by gunshot wounds, over half of the people who participated in the study had a criminal history, and one-third of them had been shot once before 5. Violence of all kinds, not just gang-related, takes a high toll among people of color. While violence is the third highest cause of spinal cord injury in the United States, among minority groups violence is the number one cause 6, responsible for 46% of new spinal cord injuries for African-Americans and 43% for Hispanic Americans 5. Unfortunately, the association between gangs, minority groups and spinal cord injury is common enough that it has created a strong stereotype; people with spinal cord injuries have told researchers that many people automatically think that a man of color in a wheelchair is a gang member or drug dealer 7.

It's your choice, but why not prove the stereotype wrong? Making the decision to leave gangs behind might be hard, but it could mean a much healthier future. (If you would like to develop or improve your skills at dealing with difficult situations or making tough choices, like deciding whether it's time to get out of a gang, check the section in this publication on decision making.)

So what are some of the alternatives for people with a past gang involvement? It's true that in the areas that gangs succeed, there might be a limit to other opportunities for achievement, high-paying jobs or educational opportunities. Add to that the challenges created by using a wheelchair, and it might seem too hard to find anything else to do except be in a gang. It's hard to change, but there are people and organizations that want to help. Talk to your case worker to find out if you can receive financial aid for high school or college education, vocational rehabilitation, or if you can get Social Security/Disability payments. You can also talk to your doctor about vocational rehabilitation. Many cities, counties and private agencies have programs specially designed to help current and former gang members to change their lives, such as job opportunities (like Homeboy Industries-Jobs For a Future in Los Angeles) and free or low-cost laser skin treatments to remove gang tattoos painlessly. And there are hospitals, schools and youth organizations nationwide that train former gang members to become motivational speakers or peer-mentors to encourage younger boys and girls to stay out of gangs in the first place, and to teach students about the lasting damage done by gunshot wounds 4 8. Two of our study participants who were former gang members chose to get training to counsel young people who are currently gang members, or who are affected by gangs in their neighborhoods. Changing young lives in this way could wind up making a difference in your own life, giving a deep-down sense of success, achievement and leadership more rewarding than what a gang could offer.

Gang membership doesn't have to be for life, and it doesn't have to cut a life short. You have the power to change, even if it's hard work. You owe it to yourself to look at all the facts and decide for yourself if it's time to leave a violent lifestyle behind.

Using the Internet to find out about how gang life relates to spinal cord injury, you might discover that many websites talk about how being in a gang or living violently can lead to getting a spinal cord injury. But there are also some interesting newspaper articles available online that look at the lives of gang members and others who have gotten spinal cord injuries because of violence, including The Last Shot, from the Boston Globe daily newspaper, and Got Your Back, from (Los Angeles) CityBeat/ValleyBeat weekly newspaper.

If you are interested in finding out about some of the alternatives to gang life mentioned in this article, try Homeboy Industries, whose "Jobs For A Future" program provides job training and placement and other services for former gang members in the Los Angeles area. To check out opportunities in your own area, try typing the name of your city and words like "ex-gang," "former gang" or "quit gang" into an Internet search engine like Google, or Yahoo! Search. You can also type in the name of your city and the words "tattoo removal" and "gang" in a search engine to find services for tattoo removal; if you are in the Los Angeles area, Homeboy Industries-Jobs For a Future has information about tattoo removal in that city.

To learn more about opportunities to speak to younger people and motivate them to stay away from gangs and violence, you might be interested in Remember Rancho!, a New Mobility Magazine article about Rancho Los Amigos National Rehabilitation Center's "Teens on Target" program and other services offered there (note: the decision to close Rancho mentioned in the article was reversed, and the facility stayed open and is doing well today). Until 2003, The University of Illinois at Chicago Institute on Disability and Human Development sponsored a project called "The Disabling Bullet", which trained people who received spinal cord injuries from gunshot wounds to be peer-mentors, that is, to encourage and motivate young people at-risk. Athough the program is no longer active, their website is still available, and has links to a number of newsletters, publications and contact information for some of the researchers and institutions who backed the project. (If you want to find out if there are mentor or speaker programs in your city, try contacting your doctor, hospital, rehabilitation facility or a school that you attended.) Make a difference in your community!

1 DeJong, G., Palsbo, S. E., Beatty, P. W., Jones, G. C., Kroll, T. & Neri, M. T. (2002). The organization and financing of health services for persons with disabilities. The Milbank Quarterly, 80, 2, 261-301.

2 Fox, S. (2004, August 15). Inmates forced to sleep on floor. The Los Angeles Times, pp. B1-B2.

3 Spinal cord injury facts and figures at a glance August 2004. Spinal Cord Injury Information Network. Retrieved September 2, 2004 http://www.spinalcord.uab.edu/show.asp?durki=21446

4 Hernandez, B., Hayes, E. P., Balcazar, F. E., & Keys, C. B. (2001). Responding to the needs of the underserved: A peer-mentor approach. The Psychosocial Process, 14, (3), 142-149.

5 Ragucci, M. V., Gittler, M. M., Balfanz-Vertiz, K., & Hunter, A. (2001). Societal risk factors associated with spinal cord injury secondary to gunshot wound. Archives of Physical Medicine and Rehabilitation, 82, 1720-1723.

6 Putzke, J. D., Richards, J. S., & DeVivo, M. J. (2001). Quality of life after spinal cord injury caused by gunshot. Archives of Physical Medicine and Rehabilitation, 82, 949-954.

7 Putnam, M., Geenen, S., Powers, L., Saxton, M., Finney, S., & Dautel, P. (2003). Health and wellness: People with disabilities discuss barriers and facilitators to well being. Journal of Rehabilitation, 69, (1), 37-45.

8 Collins, M. C. (2003, January). Remember Rancho! New Mobility. Retrieved October 28, 2004 http://www.newmobility.com/review_article.cfm?id=636&action=browse