Dr. Nadine Burke Harris explains how childhood trauma stays with us for our entire lives
“Adverse Childhood Experiences are the single the greatest unaddressed health threat facing our nation today”. Robert Block, Former President of the American Academy of Pediatrics.
In the mid 90’s the CDC and Kaiser Permanente discovered an exposure that dramatically increased the risk for 7 out of 10 of the leading cause of death in the USA.
In high doses it affects brain development, the immune system, hormonal systems and even the way our DNA is read and transcribed. People who are exposed in very high doses have triple the risk of heart disease and lung cancer and a 20 year difference in life expectancy.
The exposure is not a pesticide or packaging chemical, but childhood trauma.
Not failing a test or losing a basketball game. Threats that are so severe or invasive that they get under our skin and change our Physiology. Things like child abuse, a parent who struggles with mental issues or substance abuse.
We are trained to view childhood issues either as a welfare problem or a mental health problem.
Kids are being treated for ADD or ADHD, after making a thorough diagnosis it was clear something else was going on.
The adverse childhood experience study, 17 500 adults were asked about their exposure to adverse childhood experiences (ACES). Those include:
- physical and emotional or sexual abuse
- physical or emotional neglect
- parental mental illness, substance dependence, incarceration
- parental separation, divorce or domestic violence
For every yes, people interviewed would get a point.
The research correlated the ACES scores with health outcomes. What they found was Striking!
There’s two things:
- ACES are extremely common – 67% of the population had at least one ACE and 12.6% (1 in 8) have four or more ACES.
- They also found there was a dose response relationship between ACES and health outcomes. The higher your ACES score, the worse your health outcomes.
Someone with a score of four or more was two and a half times more likely to develop heart issues then someone with a score of zero. For Hepatitis it was also 2.5 times and for depression it was four and a half times. Suicide, 12 times. For someone with a score of 7 or more had triple the risk of lung cancer and 3 and half times the risk of heart disease, the number one killer.
People will say well of course if you have a rough childhood of course your going to drink and smoke and damage your health. But science has now helped us to understand the how the exposure of adversity affects the minds and bodies of children. It affects the nucleus accumbens – the pleasure centre of the brain that is implicated with substance abuse. It inhibits the pre frontal cortex which is necessary for impulse control and executive function. A critical function for learning. On MRI scans we see measurable differences in the Amygdala the brains fear and response center.
So there are real neurologic reasons why people exposed to high doses of adversity are more likely to engage in high risk behaviour. Even if you don’t engage in high risk behaviour your still more likely to develop heart disease or cancer. The reason for this has to do with the hypothalamic–pituitary–adrenal axis, the brain and bodies stress response system that governs the bodies fight or flight response.
If you’re getting attacked by a bear in the forest these natural responses are great. but the problem is when the bear comes home every night and this system is activated over and over and is no longer life saving or adaptive but maladaptive and health damaging. Children are especially sensitive to this repeated stress activation because their brains and bodies are still developing. High doses of adversity not only affect brain function and development, they affect the developing immune system, developing hormonal systems and even changes the way our DNA is read and transcribed.
Doctors are obligated to use this science to prevent and treat. Prevent Heal Screen.
Youth Wellness Centre’s like the one in California need to include:
- A multi disciplinary team
- Treat symptoms using best practices including home visits, care coordination, mental health care, nutrition, holistic interventions and medications where necessary.
- Educate parents about the effects of ACES and toxic stress
- Tailored approach with the understanding they may need more intensive treatment given the changes to their hormonal and immune systems.
This is a global issue
Robert Block, Former President of the American Academy of Pediatrics states that Adverse Childhood Experiences are the single the greatest unaddressed health threat facing our nation today”.
The scope and scale of the problem seems so large we don’t know how to approach it. But if we look at this for what it is, “A Public Health Crisis”, we can use the right tool kit to come up with the right solutions. From Tobacco to lead poisoning to HIV AIDS, we have a strong track record for addressing public health problems. But to do the same with ACEs and toxic stress is going to take dedication and commitment.
Why havent we taken this more seriously?
Is it because it doesn’t apply to us? The data says the opposite. The original ACEs study was done in a population where 70% were caucasian, 70% college educated. Maybe we marginalise the issue because it does apply to us. Maybe we would rather concentrate on other communities and be sick then deal with it.
Science advantage and economic realities make this option less viable now, the science is clear…. Early adversity affects the health dramatically across the lifetime. Today we are learning how to interrupt the progression from early adversity to disease and early death and 30 yrs from now a child with a high ACE score and whose behavioural symptoms go unrecognised, whose asthma management is not connected, who goes on to develop high blood pressure and early heart disease or cancer, will just be as anomalis as a 6 month mortality with HIV AIDS.
This is treatable, this is beatable. The one thing we all need is the courage look this problem in the face and to say this is real. We are the movement!
Summary by Kaiyu Bayles, full TEDX talk can be viewed here
More about the CDC-Kaiser ACE Study –
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