The crisis within How toxic stress and trauma endanger our children

Best friends and neighbors Destiny Sonnier, 9, and Akeelah Kelly, 8, shout, “Justice for Jamyla!” during a community march against violence in August. Both girls live on Ellison Drive in Ferguson and endured months of protests after the death of Michael Brown. Then, their classmate Jamyla Bolden was killed.

The white casket is low enough for most of Jamyla Bolden’s elementary school classmates to gaze directly into the face of their friend, her eyes closed, her lashes long. A childish angel adorns the interior satin lid just above the fine profile of Jamyla’s face and gazes down wide-eyed on the children. A message beneath it reads, “You shall fly with new wings.” The children have come to the wake at Wade Funeral Home on an August evening to say goodbye to Jamyla, a fellow fourth-grader at Koch Elementary School who had been shot through a window as she completed her homework on her mother’s bed. They stand in the cement block chapel next to parents and grandparents at the casket, most too shy and uncomfortable to speak. The narrow slivers of stained-glass windows barely draw in outside light. The children seek solace deep in their parents’ arms. Some of the boys put their hands in their pockets to resist the urge to reach out. Destiny Sonnier, 9, stands behind a relative in the second pew. She cannot look at her friend’s body. Destiny had spent the summer with Jamyla. They had formed a dance crew, making up complex routines, the more difficult to master, the better. “I would tell her all of my secrets and everything,” Destiny said. Akeelah Kelly, 8, had played outside with Jamyla on Ellison Drive hours before she was killed. Now, she approaches the casket, quietly and steadfast — like a grown-up little lady, her mother said. But when she returns home, she cries. Jamyla had lived in a highly segregated, low-income Ferguson neighborhood filled with young children and endless stress. Gun violence is just one part of the burden for many of Jamyla’s friends and classmates. Poverty overwhelms their parents with debt, housing and transportation problems, and they struggle to keep the power on. Their family histories include sexual abuse, domestic violence, incarceration and foster care. Two of Jamyla’s closest friends — Akeelah and Destiny — have endured many of those struggles, both before Jamyla’s death and in the months since. It has long been known that growing up in impoverished and dangerous neighborhoods dims life prospects. But now a commanding body of medical research presents a disturbing, biological picture of why. It suggests that the stress itself — if left unchecked — is physically toxic to child development and health. Brain imaging, biochemical tests, genetic testing and psychiatric trials show toxic stress ravages growing children — inviting maladies such as asthma, obesity, heart disease, high blood pressure, diabetes, kidney disease and stroke in adulthood. When children don’t get a break from the stress — when adults can’t or don’t know how to shield their children from it — their developing bodies go on a stress hormone production binge that can alter typical gene expression within their DNA. In some cases, parts of their brains are smaller and their chromosomes shorten. Those biological and developmental changes trigger lifelong health consequences that can ultimately shorten lives. Some pediatricians who treat children in mostly poor neighborhoods describe a toxic stress epidemic. “I see all these beautiful babies, and I think of all the statistics, and I can calculate which of these babies is going to have problems because their home environment is so stressed that they are never going to get the right support they need to turn on those genes to get a happy involvement in life,” said Kenneth Haller, an associate professor of pediatrics at St. Louis University School of Medicine and a fellow with the American Academy of Pediatrics. The toxic stress Haller describes isn’t limited to children of poverty. Middle-class and affluent children are not immune from the traumas of domestic violence, drug overdoses and natural disasters such as floods, to name a few. But in neighborhoods such as Jamyla’s, those stress factors are concentrated because of poverty. And that adds up to what many view as a public health crisis. “We have kids who start out looking great as infants, and as they grow I can see their parents more and more distracted by all the things in their lives like food insecurity and housing insecurity,” Haller said. “And what I ultimately see is that these kids on some level start to shut down.” A member of the dance crew Jamyla was killed in August while doing homework, when a man now in police custody shot into a bedroom window. Police do not believe she was the intended target. Jamyla was bleeding to death in the arms of a veteran police officer, a man who would later sob at her wake. Jamyla’s death on Ellison Drive happened shortly after the one-year anniversary of the fatal shooting of Michael Brown by a police officer in the same neighborhood. Everyone had hoped things would finally calm down. During the Brown protests, West Florissant Avenue, the street right behind Ellison, filled with protesters, police lines and looted and damaged stores. At night, children heard the chop of hovering police and media helicopters. Tear gas lingered like fog some mornings.

Destiny Sonnier’s fear and grief were palpable then and remain so. They linger in her own house just 300 yards down the street from Jamyla’s and in the night air that often pops with gunfire. Two years earlier, while she was living with her grandmother and dad, he disappeared. He was found shot dead and dumped in a lot in Kinloch, his legs bound by zip ties. Destiny is now being raised by her grandmother with an aunt and a cousin in the same tidy house. Her mother sometimes takes her on weekends but is busy raising Destiny’s half siblings. Destiny longs to leave the house and violence on Ellison Drive, but she knows that is unlikely. She often gets angry. “My grandma says if we move, it’s just going to be like this on the other streets,” she said. Her grandmother, Mardie Sonnier, would like to adopt Destiny, but she is certain she could never raise $1,700 in needed adoption fees. After her son was killed, Mardie Sonnier, 67, suffered a heart attack that makes it hard to breathe. She mostly depends on oxygen tanks that keep her in her small bedroom most of the day. Destiny helps the house function. Her maturity is reflected in her chores. She makes sure her grandmother takes her medicine. She reads stories to her grandmother in bed. And she plays with her little cousin. Sometimes their play includes spontaneous cartwheels and headstands in the yard after school. But that play has a twist. Last fall, on a warm late afternoon, she and her cousin stopped their flips, knelt on the grass facing each other, and put their hands together in prayer. They repeated it like a dance routine. “If we pray, we won’t get shot,” Destiny said. A friend on Ellison Drive Two days after Jamyla’s death, Akeelah Kelly attends a vigil in front of her friend’s house. She holds a balloon and cries. Photographs of her deep distress appear in the local news. Jamyla was one of the first girls to introduce herself when Akeelah moved to Ellison Drive with her mom and sister. Natasha Brown (no relation to Michael Brown) hoped suburban life would give the family a break from violence in their old St. Louis neighborhood. The house was federally subsidized and affordable. There was a neighborhood school.