If one could wave a magic wand and reduce the number of tobacco smokers by more than 10 percent, the percentage of adult alcoholics by 12 percent, the percentage of those suffering from chronic depression by more than half, most people would do so.
Although no magic wand exists, finally society is getting a grip on understanding the core causes of adult dysfunction.
From 1995 to 1997, the HMO, Kaiser Permanente, surveyed 17,000 of its members to determine the number of “adverse childhood experiences,” or ACEs, that they had growing up. Then, they looked at the correlation between the number of these experiences and the health issues that occurred throughout their adult lives. The link was direct and significant.
What are ACEs? The HMO study categorized them as verbal, physical and sexual abuse, the separation or divorce of one’s parents, domestic violence in the home, and having family members who suffered from mental illness, were drug abusers or alcoholics, or were incarcerated.
In 2011, the state of Minnesota completed its first ACE survey of 13,520 residents. The results were similar. Fifty-five percent of adult Minnesotans experienced one or more ACE in their childhood. Of those, 60 percent experienced two or more, and 15 percent experienced five or more.
The result of growing up in such an environment is both unsurprising and concerning. The more ACEs a person has, the more likely they are to smoke tobacco, be alcoholic, or suffer from anxiety, depression or asthma. The Centers for Disease Control says on its website: “The ACE findings suggest that certain experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States.”
The chances of becoming an alcoholic if one grew up with zero ACEs is 2.8 percent, but with four or five ACEs, the chances grow to 15 percent.
Only about 0.2 percent of children with zero ACEs will attempt suicide. With four ACEs, the chances grow to 11 percent, five ACEs 16 percent, 6 ACEs 29 percent and seven or more, a whopping 51 percent.
People with more ACEs are more likely to be unable to work, unable to own a home and worry more about paying the rent or buying nutritious food.
Bottom line: With five or more ACES, the chances of being in fair or poor health are doubled.
The research is showing that being exposed to ACEs at a very young age actually changes brain chemistry. Children develop ways to cope with the toxic stress in their lives that often lead to poor health, a poorer quality of life and a shortened life span.
The state has begun educating its social service agencies as well as law enforcement and the judiciary about the findings.
Now comes the hard part: implementing programs that are effective in improving resiliency among ACE victims so that they can become happy, healthy adults.
All counties offer some mental health services now, but, with a majority of the population experiencing at least one ACE, it’s safe to say that not everyone who needs help is getting it.
Only those who act out in truly disruptive, anti-social ways get attention. For many children the trauma may occur even before they reach school age. Initially their only symptom may be poor academic performance, or drinking alcohol, having sex or using illegal drugs in their early teens or before. The trauma may go unaddressed for years. The research shows, the longer trauma goes untreated, the harder it is for people to change their responses to stressful situations and to live happy, healthy, productive lives.
One of the first agencies to directly address the ACE findings head-on is the St. Cloud Police Department. In March, Paige McConkey, a mental health practitioner, was embedded in the department. His job is to be a first responder to trauma victims so that children and families get the help they need. In some instances, such as police being called repeatedly to a violent home, it is relatively easy to see that children may need help. In others, such as a death in the family or divorce, it is sometimes difficult to uncover how deeply the child has been affected.
Since the beginning, McConkey has had 40 referrals from police officers, worked with 50 children, and referred 15 of them for trauma-informed care.
While the St. Cloud experience is only anecdotal, more needs to be done to secure funding for such efforts. Now that we know childhood experiences that cause adult dysfunction, the excuses for not expanding outreach efforts to trauma victims are weakening.
By improving the resiliency of the majority of citizens who have ACEs, we can reduce the rates of alcoholism, obesity, depression, fetal death, illicit drug use, ischemic heart disease, liver disease, lung cancer, migraines, sexually transmitted diseases, smoking, suicide attempts, and unintended and adolescent pregnancies.
This has the potential to provide not only huge savings in health care and social service costs, but also to lessen the waste of so much human capital that was traumatized at an early age through no fault of its own.
For anybody interested in learning more about what works for children and families exposed to traumatic events (e.g. effective programs, treatments, grant opportunities, etc). the University of Minnesota’s Ambit Network, www.ambitnetwork.org, is a good resource. – An opinion from the ECM Publishers Editorial Board