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The root of our biggest health threat lies in our childhoods

The root of our biggest health threat lies in our childhoodsEveryone knows the experiences we have as children have a lasting impact on our lives. When we say this, we often think about the good things: the teacher who took an interest and pushed us to study; the coach who saw a spark of talent and kindled it; the grandparent who opened our ears to music.

We tend to ignore, discount, or position the bad things as challenges that spurred us on. But if a caring, nurturing and loving home life can have a positive impact on the adults we become, it is clear that neglect and chaos can harm our future adult selves.

That’s exactly what the U.S. Centers for Disease Control (CDC) and Kaiser-Permanente found in groundbreaking research conducted in the mid-1990s. The Adverse Childhood Experiences (ACE) study looked the health records and experiences of 17,500 adults and found those with four or more adverse childhood experiences were worse off physically, mentally and socially. They were more likely to have heart disease, lung cancer and diabetes; their rates of substance abuse were higher; they engaged in more risk-taking behavior; and they had a higher incidence of mental health problems, including suicide.

What are Adverse Childhood Experiences?
Adverse Childhood Experiences are grouped into three categories – abuse, neglect and household challenges. ACEs negatively impact a child’s development by triggering the body’s stress response. This continual state of stress affects and changes the child’s developing body – the immune and endocrine systems, the way DNA is encoded and transcribed and even the brain itself.

The initial study looked at 10 ACEs:
• Abuse physical, emotional and sexual
• Neglect physical and emotional
• Household Challenges such as mental illness, incarcerated relative, mother/stepmother treated violently, substance use, and loss of a parent to separation by divorce or other reason

Since the initial ACE study, hundreds of additional research papers on the impact of Adverse Childhood Experiences have been published, supporting and expanding on the initial work. Subsequent research looked at the impact of a variety of adverse childhood experiences, including racism, gender discrimination, bullying, involvement in the foster care system and community violence. These are now being included as ACEs because they create the same biologic changes as the original 10.

What the research showed
The CDC-Kaiser study showed that ACEs are common and not isolated to a particular socioeconomic group. In fact, the majority of those who participated in the initial ACE study were white, middle-class and college-educated. They were employed and enjoyed good health insurance.

Nonetheless, 26 percent had experienced one ACE; 16 percent had two; 9.5 percent had three; and 12.5 percent of respondents had four or more. More recent data, collected in 2012-2014, as part of the Behavioral Risk Factor Surveillance System, revealed 16 percent of the U.S. population had four or more ACEs.

Any number of ACEs is problematic, but four is an important number. At that level, the impact grows exponentially. Individuals with more than four ACEs:
• Are more injury prone, including traumatic brain injury, fractures and burns;
• Have more mental health issues, including depression, anxiety, suicide and PTSD;
• Have more unintended pregnancies and experience pregnancy complications and fetal death more frequently;
• Are at higher risk for HIV and STDs;
• Have triple the risk for heart disease and lung cancer and are at greater risk for diabetes;
• Engage in risky behaviors more frequently, including alcohol/drug abuse and unsafe sex;
• Have fewer opportunities for educational and occupational success and struggle financially; and
• Have a life expectancy 20 years less than their peers.

Why do ACEs have such an impact?
Adverse Childhood Experiences trigger the body’s stress response, what we commonly refer to as the fight-flight-freeze mechanism. Hormones – adrenalin, norepinephrine and cortisol – are dumped into the bloodstream, causing an increase in heart rate, shutting down the higher-thinking portions of the brain and preparing the body to do what’s necessary to survive.

This is all well and good if you’re under attack. But it’s not good if your life consists of one stress event after another. And for children, whose brains, endocrine and immune systems are very young and susceptible, the impact is devastating. ACEs literally get under their skin and change the way their bodies function.

Many of the problems we see in kids and young adults today may have their roots in childhood. So many have trouble learning in school, have difficulty trusting adults or developing healthy relationships with peers. They are diagnosed with ADHD or said to have impulse control issues.

ACE survivors may turn to substances to relieve their anxiety, depression, guilt, shame and inability to focus, self-medicating with food, nicotine, alcohol, marijuana, opioids and other substances.

Some seek to “fix” things by engaging in risky behavior – multiple sex partners or high-risk sports and activities. Others become high achievers, driven to succeed, working long hours with no time for family, recreation or life.

Mediating Adverse Childhood Experiences
Some children experience a traumatic childhood and yet emerge on the other side OK. Researchers have looked at this, too, and determined there are factors that can lessen the effects of ACEs. These include: knowing/feeling that your mother, father and other people love and care about you; having someone you can trust and talk to; the presence of a mentor, such as a coach, pastor or teacher; and feeling capable, independent and in control.

The lessons of the ACE study are clear: childhood trauma echoes throughout life. At New Vista we use a trauma-informed approach in all of our clinical services. This means we take into account any past traumas.

If you’re an adult with Adverse Childhood Experiences or if you are a parent/caregiver of a child who has experienced ACEs, there is help. New Vista, formerly Bluegrass.org, assists individuals, children and families in the enhancement of their well-being through mental health, intellectual and developmental disability and substance use services. New Vista is a nonprofit organization and our mission is to help those with limited resources.

Call New Vista’s 24-Hour Helpline with questions, for support or to make an appointment at 1.800.928.8000.

Your ACE score
Prior to your 18th birthday:
1. Did a parent or other adult in the household often or very often… swear at you, insult you, put you down, or humiliate you? or act in a way that made you afraid that you might be physically hurt?  No___If Yes, enter 1 __

2.    Did a parent or other adult in the household often or very often… push, grab, slap, or throw something at you? or ever hit you so hard that you had marks or were injured?
No___If Yes, enter 1 __

3.    Did an adult or person at least 5 years older than you ever… touch you or have you touch their body in a sexual way? or attempt or actually have intercourse with you?
No___If Yes, enter 1 __

4.    Did you often or very often feel that … no one in your family loved you or thought you were important or special? or your family didn’t look out for each other, feel close to each other, or support each other?
No___If Yes, enter 1 __

5.    Did you often or very often feel that … you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
No___If Yes, enter 1 __

6.    Were your parents ever separated or divorced?  No___If Yes, enter 1 __

7.    Was your mother or stepmother… often or very often pushed, grabbed, slapped, or had something thrown at her? Or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
No___If Yes, enter 1 __

8.    Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? No___If Yes, enter 1 __

9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
No___If Yes, enter 1 __

10. Did a household member go to prison?
No ___ If Yes, enter 1 __

Add up your YES answers – this is your ACE Score

 

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