Dr. Nancy Hardt
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The most important thing I didn’t learn in medical school is about adverse childhood experiences, also known as ACEs.
To be sure, if I had understood them then the way I do now, I would have been a better and more compassionate physician. Importantly, I would have avoided lots of mistakes.
In 2015, 5,545 children in San Francisco, CA, were reported to have experienced abuse. Of those, the reports of 753 children were substantiated. The expense to San Francisco for not preventing that abuse will cost $400,533 per child over his or her lifetime. That adds up to $301.6 million for just that one year, according to “The Economics of Child Abuse: A Study of San Francisco.”
And, because child abuse is profoundly underreported, the costs are likely to be as much as $5.6 billion for one year of children experiencing trauma, the report found.
In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.
The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.
Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.
In the final weeks of the 114th Congress, Senator Heidi Heitkamp (D-ND) welcomed her colleague Senator Dick Durbin (D-IL) as a new host for the third and final briefing on addressing adverse childhood experiences (ACEs). The December 1 briefing focused on public policies to improve coordination, prevention and response to childhood trauma.
ACEs comes from the CDC-Kaiser Permanente Adverse Childhood Experiences Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with an accumulation of childhood adversities — including divorce, racism, living with an alcoholic parent, and physical abuse — have a higher risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.
Donna Jackson Nakazawa
More than 133 million American adults — one in two of us — suffer from a chronic condition, including autoimmune disease, fibromyalgia, digestive disorders, migraines, back pain, depression, diabetes, cancer and chronic pain. A recent study published in JAMA Internal Medicine found that those of us in our 40s, 50s and 60s are twice as likely as our parents were to suffer from debilitating chronic conditions in middle age.
I’m one of those statistics. I’ve spent much of the past decade navigating my life around health crises. Twice I’ve been paralyzed by Guillain-Barre Syndrome, an autoimmune disease similar to multiple sclerosis, but with a more sudden onset and a wider array of possible outcomes. Other diagnoses — low blood cell counts, thyroiditis and the need for a pacemaker — have also complicated my health and my life.
Cutting-edge research tells us that experiencing childhood emotional trauma can play a large role in whether we develop physical disease in adulthood. In Part 1 of this series we looked at the growing scientific link between childhood adversity and adult physical disease. This research tells us that what doesn’t kill you doesn’t necessarily make you stronger; far more often, the opposite is true.
Adverse Childhood Experiences (ACEs)—which include emotional or physical neglect; verbal humiliation; growing up with a family member who is addicted to alcohol or some other other substance, or who is depressed or has other mental illness; and parental abandonment, divorce, or loss — can harm developing brains, predisposing them to autoimmune disease, heart disease, cancer, depression, and a number of other chronic conditions, decades after the trauma took place.
