CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Conference in Hammond discusses 'the most powerful determinant of health and social well-being'

Times - 7/22/2019

Jul. 22--HAMMOND -- Two of the foremost experts on childhood trauma spoke at a conference here Thursday about what one of them called the "largest public health discovery of all time."

That would be a 1990s Centers for Disease Control and Prevention study on the lifelong health and social effects of so-called adverse childhood experiences, or ACEs.

One of that study's authors, Dr. Robert Anda, gave a presentation at Thursday's ACEs Conference at Purdue University Northwest, hosted by Franciscan Alliance.

Roughly 500 people from a variety of sectors -- including education, health care, criminal justice, public safety and child protective services -- gathered to learn how they could blunt the impacts of childhood trauma and ultimately prevent it.

The idea for the event came out of the most recent community health needs assessment that Franciscan Alliance -- along with all other nonprofit hospitals -- are required to do every three years. Katie Hill-Johnson, administrative director of community health improvement at Franciscan Alliance, said the identified needs tended to have a common component: their link to childhood trauma.

"It's the root and cause of so many things," she said.

Franciscan Alliance has been holding screenings across the state of the documentary "Resilience," about the ACEs study, and also hosted an ACEs conference Friday in Indianapolis that was attended by about 1,500 people.

Anda said he started down this path of research after realizing that, as a physician, he was "just telling people what to do" rather than digging into the root causes of their problems, which were often social and not medical in nature.

In the mid-1990s, he got funding from the CDC -- not without pushback, he said -- and surveyed more than 17,000 patients in the Kaiser Permanente hospital system about their childhood experiences and health status. The results shocked him.

Without fail, for a variety of health and social problems, the more adverse childhood experiences people had, the more likely they were to have trouble later in life. The experiences included physical and sexual violence, neglect, parents divorcing or separating, and parental substance abuse, mental illness and incarceration.

A higher ACE score meant a higher risk factor for such things as early initiation of drug use, teen pregnancy, drug addiction, committing felonies, academic failure, truancy, liver disease, heart disease, unemployment, homelessness and use of public assistance. Anda said ACEs are also a big contributor to the "prison pipeline" and "one of the the pathways into poverty." Thus, ACEs come at a high cost to society.

He said his research found ACEs, which he called "the most powerful determinant of health and social well-being," to be responsible for more than three-fourths of intravenous drug use, two-thirds of people reporting "life dissatisfaction," and half of cases of alcoholism and depression, suicide attempts, disability days, and incidents of domestic violence.

There's a physiological explanation.

Stress activates the body's fight-or-flight system, which is invaluable if we're in danger but also releases the hormone cortisol, which can be toxic in large or repetitive doses. Cortisol has been found to kill brain cells in studies of animals. Stress, particularly when it's unpredictable or severe, "can become like a poison to your body," Anda said.

Most brain development happens in the first few years of a person's life and so-called toxic stress during this time can have a lasting impact, changing the architecture of the brain. This social, emotional and cognitive impairment can lead to risky behaviors, which increase the likelihood of a variety of poor health and social outcomes.

"The memories of our experiences are stored in our bodies," Anda said.

This can lead to what Anda labeled as a "intergenerational cycle of stress," in which adults who grew up in stressful environments raise their own children in the same way.

Anda, along with Laura Porter of the Washington State Family Policy Council, went on to found ACE Interface, which aims to build "self-healing communities" that mitigate the effects of and prevent adverse childhood events.

Many of the systems that encounter victims of childhood trauma -- criminal justice, education, health care -- aren't equipped to treat it, Anda noted. Thus it's important for the people working in those systems to become "trauma-informed," which Anda explained as a "shift from blaming and shaming ... to understand what's happening and how the developmental flow and biological adaptation has led (people) to where they are."

Porter cited research Thursday showing that the vast majority of court-involved youth had been suspended from school by the second grade, meaning kids that weren't "welcome" at home or school ended up in the criminal justice system. "I believe we've been in this vicious cycle: Society responds by rejection and ejection. We respond by kicking people out," she said. "This leads to higher rates of adult adversity."

Many of those adults, she noted, go on to have children of their own.

Porter said, of the ACEs study: "I came to believe it's the largest public health discovery of all time."

She gave examples of some "self-healing communities":

* After seeing research that more than half of people who had three adverse experiences as kids and another three as adults reported not being able to function in daily life, one local health department allowed women to drop in to its Women, Infants and Children office rather than schedule appointments. Attendance went up dramatically.

* One law enforcement agency would, rather than arrest first-time, nonviolent, juvenile offenders, give their families the option of receiving services so they could all heal. "Recidivism dropped to nothing," Porter said.

* One school hired staffers who would essentially shadow students, going to wake them up if they didn't show up to class or sit next to them until they behaved. The school, a tribal one where many parents had been abused as kids, also moved parent-teacher conferences off-site -- and the attendance of them shot up. Graduation rates rose to 100%, and most kids went on to higher education, Porter said.

"It takes a small shift to make a big change," she said.

___

(c)2019 The Times (Munster, Ind.)

Visit The Times (Munster, Ind.) at www.nwitimes.com

Distributed by Tribune Content Agency, LLC.