The Decisions They Are-A-Changin’

Bob Dylan sang in his iconic The Times They Are-A-Changin’:

Come gather ’round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone.
If your time to you
Is worth savin’
Then you better start swimmin’
Or you’ll sink like a stone
For the times they are a-changin’.

Come writers and critics
Who prophesize with your pen
And keep your eyes wide
The chance won’t come again
And don’t speak too soon
For the wheel’s still in spin
And there’s no tellin’ who
That it’s namin’.
For the loser now
Will be later to win
For the times they are a-changin’.

The Waters Have Grown

We are on the verge of a sea-change in our thinking about decision making. Rather than the universal and utilitarian approach of rational choice and subjective rankings, we are coming to recognize that our every-day decisions, the ones that drench us to the bone, that sink or change us, come in the moment. Our choices are driven by often poorly articulated but deeply held values, linked to the meanings culture give us, and shaped by the unequal circumstances of our lives.

Continue reading “The Decisions They Are-A-Changin’”

Putting Two and Two Together

One headline this week: “Neglect, Abuse Seen in 90,000 Infants” which starts: “About 1 in 50 infants in the U.S. have been neglected or abused, according to the first national study of the problem in that age group.”

Another headline this week: “Childhood Mental Health Problems Blight Adult Working Life” whose first line repeats the mantra: “Mental health problems in childhood blight adult working life, suggests research published ahead of print in Occupational and Environmental Medicine.”

Putting them together? We can look to the Adverse Childhood Experiences study, based on information from more than 17,000 members of the Kaiser Permanente HMO in California. Here’s part from the CDC summary:

“As the number of Adverse Childhood Experiences increase, the risk for the following health problems increases in a strong and graded fashion:

-alcoholism and alcohol abuse
-chronic obstructive pulmonary disease (COPD)
-depression
-fetal death
-health-related quality of life
-illicit drug use
-ischemic heart disease (IHD)
-liver disease
-risk for intimate partner violence
-multiple sexual partners
-sexually transmitted diseases (STDs)
-smoking
-suicide attempts
-unintended pregnancies