By Sara Hossaini
A first-of-its kind report released Wednesday suggests Californians are facing a hidden public health crisis that stems from childhood trauma.
Researchers from the San Francisco-based Center for Youth Wellness and Public Health Institute in Oakland aim to shed light on how early adverse experiences, such as abuse, neglect, and household dysfunction -- including divorce and parental incarceration -- might impact a child's health for a lifetime.
Dr. Nadine Burke Harris is a pediatrician and founder of the Center for Youth Wellness. She says the study looked at data from more than 27,000 surveys conducted by the California Behavioral Risk Factor Surveillance System over four years between 2008 and 2013.
She says the results surprised even her. For starters, so-called adverse childhood experiences, or ACEs, are common across race, income, education and geography. Nearly 62 percent of Californians reported at least one traumatic childhood event, and one in six had experienced four or more. People in the northern rural counties of Humboldt and Butte reported the most ACEs. The lowest numbers came from Santa Clara and San Mateo counties, where just over half of respondents reported such experiences.
"People sometimes assume this is a low-income issue," says Burke Harris, "This is everybody's burden, every taxpayer."
In part, she says this is because traumatic childhood experiences can make a child's natural response to stress go haywire and cause lasting damage. This is known as childhood toxic stress, a concept Burke Harris says has just begun to gain traction over the past five years.
"Toxic stress affects the entire developmental trajectory of the child," Burke Harris says, "the changes to your DNA, the changes to your hormonal systems, as well as the changes to your immune system and neuro-development."
High doses of such adversity increase risk of chronic diseases, heart disease, asthma, even Alzheimer's disease. People with four or more ACEs are poorer, less likely to get a college degree and are nearly 40 percent more likely to be unemployed later in life.
The term "ACEs" was first coined in the late 1990s after Vincent Felitti of Kaiser in conjunction with a Centers for Disease Control researchers published the original ACEs study. But that study was in Kaiser members who were overwhelmingly caucasian and most had a college education. The "Hidden Crisis" report is the first to use sample size more representative of the demographics of California, Marta Induni, research director at the Public Health Institute, told the Chronicle of Social Change.
Burke Harris is hopeful that momentum around early interventions will save lives and money. She's calling for ACE training for physicians, in-home screenings, and what she calls the gold standard: two-generational services that includes both parents and children, like that utilized by University of California San Francisco's Infant Parent Program and Child Trauma Research Program.
"Where a child has a high ACE score, often times you have a parent with high ACE score and that often predisposes for the conditions the child is in," says Burke Harris, With two-generational services, "we're seeing improved school functioning, and a reduction in chronic disease outcomes, like asthma hospitalizations, et cetera."
Burke Harris says more research is needed on the impact of other types of negative childhood experiences that the original surveys did not consider, including bullying, racism and community violence.