Understanding the Impact of Childhood Trauma on Health
Childhood trauma can have profound and lasting effects on a person's health throughout their lifetime. To understand just how significant these consequences can be, the CDC and Kaiser Permanente conducted a study that revealed a dramatic connection between early trauma and the risk of developing serious health conditions. This discovery has significant implications for how we approach healthcare and support individuals affected by trauma.
The Discovery of ACEs
The Adverse Childhood Experiences (ACEs) study, conducted by Dr. Vince Felitti at Kaiser and Dr. Bob Anda at the CDC, asked 17,500 adults about their exposure to various types of trauma during childhood. These included physical, emotional, or sexual abuse; physical or emotional neglect; parental mental illness, substance dependence, incarceration; parental separation or divorce; or domestic violence. Each "yes" to these questions added a point to the individual's ACE score.
The findings were striking. Sixty-seven percent of the population had experienced at least one ACE. Additionally, 12.6 percent had four or more. The study also found a relationship between ACE scores and health outcomes: the higher the ACE score, the worse the health outcomes. For instance, individuals with an ACE score of four or more were twice as likely to develop chronic obstructive pulmonary disease (COPD) and hepatitis, four and a half times more likely to suffer from depression, and twelve times more likely to attempt suicide.
The Science Behind ACEs
Understanding the impact of childhood trauma on health involves exploring the neurological and physiological changes that occur. Trauma affects brain development, particularly areas like the nucleus accumbens, which is associated with pleasure and reward, and the prefrontal cortex, crucial for impulse control and executive function. Additionally, trauma affects the amygdala, the brain's fear response center. These changes explain why individuals exposed to high doses of trauma are more likely to engage in high-risk behaviors.
However, even without these behaviors, individuals with high ACE scores are still at increased risk for health issues like heart disease and cancer. This is due to the hypothalamic–pituitary–adrenal axis, which governs the body's stress response. Chronic activation of this system, due to ongoing trauma, leads to health-damaging effects, particularly in children whose brains and bodies are still developing.
Broader Implications of Childhood Trauma
The broader implications of childhood trauma on health are significant. For example, a person with an ACE score of seven or more has triple the lifetime risk of lung cancer and three and a half times the risk of ischemic heart disease, the leading cause of death in the United States. The adverse effects of childhood trauma are not limited to high-risk behaviors like smoking or substance use; they extend to physiological changes that increase susceptibility to various diseases.
Personal and Professional Insights
Dr. Nadine Burke Harris, a pediatrician, witnessed the impact of childhood trauma firsthand in her practice. After finishing her residency, she chose to work in Bayview-Hunters Point, one of San Francisco's poorest neighborhoods. There, she noticed a trend of children being referred for ADHD, but upon closer examination, she found that many of these children had experienced severe trauma.
Inspired by the ACE study, Dr. Burke Harris changed her clinical practice. She began routine screening for ACEs and developed a multidisciplinary treatment approach to support affected children. Her work led to the creation of the Center for Youth Wellness, aimed at preventing, screening, and treating the impacts of ACEs and toxic stress.
A Call to Action
Addressing the impact of childhood trauma on health requires a comprehensive approach. Routine screening for ACEs should be part of every child’s regular physical exam. For those who screen positive, a multidisciplinary treatment team can provide support through home visits, care coordination, mental health care, nutrition, holistic interventions, and medication when necessary. Educating parents about the impacts of ACEs is also crucial.
Tailoring care for children with high ACE scores is essential. For example, children with asthma or diabetes may require more aggressive treatment due to the changes in their hormonal and immune systems caused by trauma. Understanding these needs allows healthcare providers to offer more effective care.
The Movement for Change
Dr. Robert Block, former President of the American Academy of Pediatrics, stated that "adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today." Recognizing childhood trauma as a public health crisis is the first step toward addressing it. The United States has a strong track record of tackling public health issues, and with determination and commitment, we can replicate this success with ACEs and toxic stress.
A national response to childhood trauma is crucial. Many people may think this issue does not apply to them, but the data shows otherwise. The original ACE study population was predominantly Caucasian and college-educated, indicating that childhood trauma affects individuals across all demographics.
Empowering Families, Elevating Lives
The impact of childhood trauma on health is profound and far-reaching. Early adversity affects brain development, the immune system, and overall physiology. This leads to increased risks of chronic diseases and mental health issues. Addressing this issue requires a comprehensive approach, including routine screening, multidisciplinary treatment, and education.
At the Lycoming-Clinton System of Care, we are dedicated to supporting families and children who have experienced trauma and serious emotional disturbances. Our team works tirelessly to connect families with the necessary resources and care, ensuring that every child has the opportunity to heal and thrive. By working closely with families and provider partners, we aim to create a nurturing and understanding environment that fosters resilience and recovery. If your family is in need of assistance, we are here to help you navigate this journey and find the support your child deserves. Together, we can create a healthier future for our children and our communities. Send us a message to get started!