Adverse Childhood Experiences
Landmark research, known as the Adverse Childhood Experiences Study, was conducted at Kaiser Permanente from 1995 to 1997 with 17,000 Health Maintenance Organization members who completed confidential surveys regarding their childhood experiences and current health status and behaviors. The findings from ACEs study revealed more than half of the respondents reported at least one ACE, while one-fourth reported more than two. Significant findings included realizing a graded relationship between the number of categories of childhood exposure produced an increase of adult health risk behaviors and diseases. Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had a four to twelve times increase of health risks for alcoholism, drug abuse, depression, and suicide attempt; a two to four times increase in smoking, increased sexual promiscuity and sexually transmitted disease.
However, ACEs are only one part of the story. They are NOT destiny. We now know what is predictable is also preventable. By understanding ACE scores and how they may have contributed to individual health or the health of a community is important, but the good news is that trauma can be overcome through resilient skills and the caring support from others. “Research shows that Positive Childhood Experiences (PCEs) buffer against the health effects of adverse ones. The proactive promotion of positive childhood experiences for children may reduce risk for adult depression, poor mental health and promote adult relational health.” * (JAMA Pediatrics, Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample) Every city needs to examine how they are supporting the development of protective factors among children and adolescents in order for them to avoid behaviors that place them at risk for adverse health and educational outcomes. These factors increase an individual’s ability to avoid adopting unhealthy coping skills, and promote social and emotional competence to thrive in all aspects of life, now and in the future.
Since 2014 recommendations from the Substance Abuse Mental Health Services Administration (SAMHSA) have been for communities to “address trauma with a multi-pronged, multi-agency public health approach inclusive of public education and awareness, prevention and early identification, and effective trauma-specific assessment and treatment.” * (SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach) Education and training are needed in every community to help service systems to pause, gain a basic realization about trauma and how it can affect individuals and then take inventory that they are not re-traumatizing individuals in their service delivery. Since 2015, I’ve passionately dedicated myself to see that these practices have been applied in Northeast Tennessee, Southwest Virginia and beyond. As a result, many champions have emerged now understanding ACEs science who are building community resilience through inspiring programming within a diversity of professional sectors.