The Coronavirus Case Explosion in California (and how an entire scientific field is being ignored).

In this piece, I will begin by discussing some broad strokes of my field’s science and then hone in on how it can be useful within one specific area within the United States: the current explosion of California’s coronavirus cases. 

I have chosen to concentrate on this subject specifically as it is where I live. I also believe it is emblematic of how individual behavior is essential, particularly within societal problems (such as a global, deadly pandemic).

My “big picture hypothesis” is: If behaviorism principles, scientific research (behavioral economics, etc.- all of it) had been woven into the culture in terms of infrastructure and political discourse shortly after this field had first taken hold as an industry (and now it is mostly pigeonholed and criticized, in one specific “market”- for a good reason, I would argue), I don’t think the government as a whole– and therefore the associated coronavirus response– would be an as disastrous condition as it is in today.  To be clear, I think there is plenty of blame to go around (federal government being front and center). Still, I also think a lot (most?) of the blame goes back to decades of poor infrastructure, a disregard for the impact of one’s direct environment from a scientific standpoint (emphasis on nature over nurture). Just general disregard for human life, in general, has gotten us in the mess we are in today.

First, a thought exercise…

Let’s think about the general concept of “diversity” for a moment.  This has become a bit of a buzzword in many ways (unfortunately), but I don’t think we ever think about this word’s actual substance. At its root definition, I would argue that this word gets to an individual’s individualistic nature (or “pieces”).  This basic definition may seem obvious, but what does that mean?  What makes us an “individual” and who makes that determination (“If a tree falls in a forest” type of thinking, a little…”)?

What is Applied Behavior Analysis?

“Applied behavior analysis is the science in which the principles of the analysis of behavior are applied systematically to improve socially significant behavior, and experimentation is used to identify the variables responsible for behavior change.” (Cooper, Heron, and Heward (2007)

Applied Behavior Analysis (ABA) is a vast scientific field used within autism, special education, traumatic brain injury, general parenting, gerontology, law enforcement, organizational behavior management (workplaces), etc.  ABA specifically is the science of applying interventions to affect change towards a person or person’s behavior based on behaviorism principles.  Think B.F. Skinner, Pavlov, etc., type figures. It is important to note that science, particularly the experimental elements of this field, focuses on *individual behavior* rather than the collective human experience. 

However, while I (and I’m sure other Behavior Analysts) certainly place great value on personal observation of 1:1 observation from a scientific perspective, we also place great significance on putting those solitary, discrete behaviors from individuals into a “bucket” of sorts to understand those around us further.  To be clear, I am certainly not disputing that collective action or even studying large populace sectors is ineffective or not needed. Of course not. However, I hypothesize that it is vital to parse out smaller factors within that collaborative, larger context to the missing scientific practice.

Single Subject Design

Much of the scientific research on and related to Applied Behavior Analysis is conducted under a “single-subject design” format.  Defined more specifically: “Single-subject research (also known as single case experiments) is popular in the fields of special education and counseling. This research design is useful when the researcher attempts to change an individual’s behavior or a small group of individuals and wishes to document that change. Unlike true experiments where the researcher randomly assigns participants to a control and treatment group, the participant serves as both the control and treatment group.”

This means that the research subject – most often a person, but it CAN be a single “entity”– acts as their control group.  You employ this research method all the time without knowing it.  For example, if you have ever gone on a diet, you are nearly utilizing an elementary example of a single-subject design. You are acting as your “own” control group by “applying” the intervention of a diet– regardless of what form that may take– and then you measure your success (dependent variable) through the time you are on that diet.  Thus, you are acting as your “own” control group! Pretty cool!

However, the above speaks to a few more technical aspects of my field.  It is more important, in my view, that we recognize that behavior analysis, and my profession as a whole, should be viewed within the context of a more “useful” context, such as finding solutions to social problems, among other valuable uses.

Social Problems & Behavior Analysis

We all commonly think about behavior analysis regarding things like Criminal Minds or another true-crime drama.  However, behavior analysis can also be used before it gets to the point where a crime occurs. Board Certified Behavior Analysts can be employed to mitigate the social problems that often, directly and indirectly, contribute to criminal behavior.

Or, as stated in Mattaini and Thyer (1996, p. 2): “…the science of behavior has much more to offer than is widely recognized”. 

On The Current Coronavirus Crisis in California

Coronavirus cases are exploding exponentially in California, USA currently. The United States is not doing well as a whole, to be fair, but California, in particular, has had an alarming increase.  The number of deaths has surpassed 31,000 as of January 10th, 2021. 

If you have been watching any amount of television coverage lately, you may have noticed that it seems medical experts are having trouble pinpointing an exact reason why this explosion in cases has occurred.  They also seem puzzled as to why it has explicitly happened at this point (to be clear, medical experts are, of course, able to pinpoint reasons in terms of the virology “movement” itself and link specific spreads to specific events, etc.- but doctors don’t seem to have a particular explanation for 1.) Why California? and 2.) Why now?. This is particularly puzzling when California has been a state that has mostly kept things under control until recently.

However, there are various reasons why cases are exploding within California, particularly now. I believe this is due to a variety of socioeconomic, behavioral, lifestyle, cultural, etc. type factors that have contributed to this disaster (again, in addition to the virology/mutation reasons). I believe that these ultimately come down to individualistic factors that have been largely ignored for decades. Please note that the unique factors I mention below will be based on my own experiences as a resident of California and, more significantly, as a behavioral scientist who has worked with the general public for the last six or so years throughout Northern and Southern California.

For reference, I worked in the Lancaster, California area (near Edwards Air Force base, in Southern California) for several years in various positions that required me to go into different homes, schools (both public and private), across socioeconomic “lines,” zip codes, etc.—all over. I worked with children with autism, helping kids achieve their goals within the school environment through their Special Education programs, etc.- all of these roles required me to go “into” many, many public and private locations and observe events and behaviors first-hand.

In the end, I lived in Southern California from 2011-2016, and I had the privilege of spending thousands of hours with hundreds of families throughout that region.  It was during this time that I earned a Bachelor’s degree in Criminal Justice.

I then moved to the Sacramento, California area (where I currently live) and worked in similar positions until I earned my master’s degree and became a BCBA.  I have worked with hundreds of families since moving to this area (I no longer work in that role). Thus, with this educational and personal background in mind, here are some reasons from a Board Certified Behavior Analyst that has seen a whole lot of California over the years why coronavirus cases are exploding in California. 

Please note that these reasons are not necessarily “bad”; however, my point is that they are overlooked and are not being accounted for within the coronavirus epidemic here specifically, accounting for human behavior within individual lifestyles and environments that in itself is the problem.

1.) Healthcare Access (Mental and Physical)

Healthcare is a mess in general in America. It’s become a bit of a joke, I know. Each state has a specific set of problems, and California is no different.

In my roles mentioned above, I was classified as a healthcare worker and contracted with many insurance companies.  I also worked with socially funded agencies such as Regional Centers and even different companies when I accessed health insurance through my employment.  I was also a “military spouse” for a total of nine years, so I experienced the closest thing we have to socialized medicine in America- Tricare.  Suffice to say that I have a lot of personal and professional experience with healthcare in America, specifically in California, from various angles.

So please hear me out when I say this: it is incredibly tough to navigate the system even once you are “in” (meaning, if you manage to be in a position- usually employed full-time in the United States- even to have access to health insurance).  There are excessive rules, procedures, and bureaucratic red tape to cut through to get simple help or procedures completed, at least in my experience. And again, I have seen this from the consumer side of things, as a medical health professional, and from within the closest thing we have to socialized medicine in this country. 

I point all of this out in the context of behavior analysis/behaviorism, as it is crucial when it comes to something called “response effort.”  Response effort is precisely what it sounds like: it is essentially the effort you need to put forward to perform any behavior.  

This is why it ultimately matters, though:

So, let’s be honest; we are all, usually, trying to reduce our response efforts. The only exception to this (conscious exception) would be working out, increasing weight, challenging yourself (even outside of athletics), etc. Otherwise, I would wager that most of us are either consciously or subconsciously trying to reduce the “response effort” it takes to perform any specific task. 

I mention this as, theoretically, reducing this response effort to perform a task may help increase a behavior (such as getting tested for coronavirus and subsequently treated, isolating, etc.). “A response requiring great effort diminishes more quickly during extinction than a response requiring less effort” (Cooper, Heron, and Heward, 2019).  

The essence of my argument is- a logistically disastrous healthcare system makes things like pandemics even more deadly. This is why studying things like “response effort” and the impact it has on an individual’s engagement with the healthcare system (particularly within the context of a pandemic) seems even more prudent. However, this is not an area that is even looked at, nor is it vigorously researched within the realm of social issues or social to solution issues. Imagine if properly funded behavioral research revealed that we could likely get to 85% herd immunity three months earlier if access to the vaccine were made easier through X, Y, Z way? I am making this up as an example, but my point is- this research is not being done, or it is not being seen as a priority in the fight against this social/health crisis (or others, for that matter).

2.) Housing

a. Homelessness there is a vast homeless population here, and I think that is commonly known.  However, the problem is much more expansive beyond the larger metropolitan areas you are likely conjuring up in your mind right now.

If you have ever visited California, you have probably gone to Los Angeles or perhaps a surrounding major metropolitan area (San Diego, etc.).  However, most visitors to California do not see the homeless populations often “tucked” within almost every other nook and cranny of California as well- not just in the larger, touristy cities you visit.  I am referring to cities that are a bit more residential and cheaper to live in than Los Angeles, San Diego (think San Bernandino, 

Still, these neighborhoods’ occupants are no less likely to call for law enforcement assistance for these transient homeless populations, as you would imagine in those ritzier environments that you probably do see the occasional homeless individual. As you can imagine, this type of situation is not conducive to adequately prevent the spread of a deadly pandemic. It just isn’t, and it should also be mentioned/acknowledged that the homeless population in California. 

b. Multi-generational housing-This was one of the coolest things I saw, coming from a small family myself.  More often than not, at least two generations in the house would be what would traditionally be considered the “nuclear” family and an aunt or uncle, etc., that would be living in a spare bedroom or perhaps a separate wing of the house.

Incredibly heartwarming (in most circumstances, ha!), but you can only imagine how this type of housing situation would pose a challenge during the pandemic. Now, does this mean that multi-generational housing is problematic? Of course not, but it does not seem to be something that is mentioned enough as a factor to be considered in the fight to combat the coronavirus pandemic.

For instance, if there are a few generations in that home, perhaps there could be extra, focused assistance given to the ONE individual that works in that home, even though they may not be the vulnerable individual themselves or even work in a public-facing role, but because they work outside of the house. So, by protecting that person (whether that is via financial help or otherwise), you would be covering the vulnerable individual within that home.

This type of “additional” medical service could only be feasible if we invest and pledge to look at the populace’s diversity, which allows for these types of situations to be examined more thoroughly. However, until we look at government/society in a more individualistic manner (and invest in this type of research, and educate/legislate/rethink policy accordingly, these types of challenges will continue to mount as they go unexamined.  

Conclusion

The above are only a couple of examples that happen to be pretty specific but also expansive (I think) in terms of how individual behavior could be complicated enough to the point of being potentially disruptive to collective measures imposed on an entire populace (even on a city/county level).

If this all seems a bit much and overblown, I want to remind you that the coronavirus really “got going” in the United States with 15 cases in Washington. Do you remember that? If a Behavior Analyst had been assigned to each of those cases, environmental factors could’ve been studied to determine how to reduce risk best, and then that individualized approach to each case could’ve allowed for this disaster to have been avoided.  Really.  There is a story behind how each of those 15 cases “got out” that we may never know. But those are 15 stories of the possibility that was ultimately lost, though.

Of course, there are many other reasons why the coronavirus is spreading rapidly throughout California and elsewhere.  But the larger point is that these are attributes that I believe are perhaps more prevalent in California (I grew up in upstate New York) and maybe contributing substantially to the spread.  While some of these factors may not fix things overnight, I think most would agree that an informed populace is most advantageous even if recognized.  And the fact that these types of things are not being discussed within the larger coronavirus conversation, I think that is a fact that should change, sooner rather than later. Continuing to view individuals in a world of diversity as a collective is a blind spot that needs to change. Otherwise, we are cherry-picking scientific research, to the chagrin of progress, future generations, and scientific advancement as a whole.

Citation

Cooper, J., Heron, T., & Heward, W. (2007). Applied Behavior Analysis (2nd ed.). Pearson.

Mattaini, M. A., & Thyer, B. A. (1996). Finding Solutions to Social Problems: Behavioral Strategies for Change (0 ed.). Amer Psychological Assn.

Siegle, D. (2018, September 13). Single Subject Research. Educational Research Basics by Del Siegle. https://researchbasics.education.uconn.edu/single-subject-research/

 

 

 

 

 

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*Please know I do not reinforce maladaptive behavior, though. 😉

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