ºÚÁÏÕýÄÜÁ¿ Note: Dr. Nadine Burke Harris offers a ‘TED Talk’ about childhood trauma that reflects on the science of Adverse Childhood Experiences (ACEs), the mission to inform and impact our health industry around it, and the success she has reached in one intervention setting in San Francisco. A few excerpts from her talk are below, but watch the whole inspiring presentation here:
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How Childhood Trauma Effects Health Across a Lifetime
Ted.com; Nadine Burke Harris, 9/2014
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In the mid-’90s,Ìýthe CDC and Kaiser PermanenteÌýdiscovered an exposure that dramatically increased the riskÌýfor seven out of 10 of the leading causes of death in the United States.ÌýIn high doses, it affects brain development,Ìýthe immune system, hormonal systems,Ìýand even the way our DNA is read and transcribed.ÌýFolks who are exposed in very high dosesÌýhave triple the lifetime risk of heart disease and lung cancerÌýand a 20-year difference in life expectancy.ÌýAnd yet, doctors today are not trained in routine screening or treatment.ÌýNow, the exposure I’m talking about is not a pesticide or a packaging chemical.ÌýIt’s childhood trauma.
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The Adverse Childhood Experiences StudyÌýis something that everybody needs to know about.ÌýIt was done by Dr. Vince Felitti at Kaiser and Dr. Bob Anda at the CDC,Ìýand together, they asked 17,500 adults about their history of exposureÌýto what they called “adverse childhood experiences,” or ACEs.ÌýThose include physical, emotional, or sexual abuse;Ìýphysical or emotional neglect;Ìýparental mental illness, substance dependence, incarceration;Ìýparental separation or divorce;Ìýor domestic violence.ÌýFor every yes, you would get a point on your ACE score.ÌýAnd then what they didÌýwas they correlated these ACE scores against health outcomes.ÌýWhat they found was striking.ÌýTwo things:ÌýNumber one, ACEs are incredibly common.ÌýSixty-seven percent of the population had at least one ACE,Ìýand 12.6 percent, one in eight, had four or more ACEs.ÌýThe second thing that they foundÌýwas that there was a dose-response relationshipÌýbetween ACEs and health outcomes:Ìýthe higher your ACE score, the worse your health outcomes.ÌýFor a person with an ACE score of four or more,Ìýtheir relative risk of chronic obstructive pulmonary diseaseÌýwas two and a half times that of someone with an ACE score of zero.ÌýFor hepatitis, it was also two and a half times.ÌýFor depression, it was four and a half times.ÌýFor suicidality, it was 12 times.ÌýA person with an ACE score of seven or moreÌýhad triple the lifetime risk of lung cancerÌýand three and a half times the risk of ischemic heart disease,Ìýthe number one killer in the United States of America.
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The other thing that happens when you understand this scienceÌýis that you want to shout it from the rooftops,Ìýbecause this isn’t just an issue for kids in Bayview.ÌýI figured the minute that everybody else heard about this,Ìýit would be routine screening, multi-disciplinary treatment teams,Ìýand it would be a race to the most effective clinical treatment protocols.ÌýYeah. That did not happen.ÌýAnd that was a huge learning for me.ÌýWhat I had thought of as simply best clinical practiceÌýI now understand to be a movement.ÌýIn the words of Dr. Robert Block,Ìýthe former President of the American Academy of Pediatrics,Ìý“Adverse childhood experiencesÌýare the single greatest unaddressed public health threatÌýfacing our nation today.”ÌýAnd for a lot of people, that’s a terrifying prospect.ÌýThe scope and scale of the problem seems so large that it feels overwhelmingÌýto think about how we might approach it.ÌýBut for me, that’s actually where the hopes lies,Ìýbecause when we have the right framework,Ìýwhen we recognize this to be a public health crisis,Ìýthen we can begin to use the right tool kit to come up with solutions.ÌýFrom tobacco to lead poisoning to HIV/AIDS,Ìýthe United States actually has quite a strong track recordÌýwith addressing public health problems,Ìýbut replicating those successes with ACEs and toxic stressÌýis going to take determination and commitment,Ìýand when I look at what our nation’s response has been so far,ÌýI wonder,Ìýwhy haven’t we taken this more seriously?
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