Two decades ago social scientists published landmark research that uncovered some previously undiscovered insights into stressors that affect developing minds. The Adverse Childhood Experiences (ACEs) study quantified the traumas that affected 17,000 adult patients, years before.
The more recent work by a pediatrician is connecting the dots between those traumatic experiences and physical ailments that are all too common among children in this country such as ADHD, diabetes, asthma, and others.
"What I observed was this trend - that my patients who often had the worst outcomes were also the ones who had some pretty significant exposures to adversity. And I wanted to understand the science behind that pattern," explains Dr. Nadine Burke Harris, founder and CEO of the Center for Youth Wellness in San Francisco and author of The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.
There are three classifications of stress response: positive, tolerable, and toxic, Harris explains. Childhood adversity is connected to the ways young bodies respond to toxic stress that can occur when exposed to severe, chronic, or prolonged adversity. She says abuse, neglect, domestic violence, or living in a household with mentally ill or substance dependent adults can cause long term changes in a child's stress response system from brain structure and function, hormone levels, immune system, to how DNA is read and transcribed.
Harris notes that as a society, we are not systematically addressing childhood adversity as a root cause of many health and social problems we're struggling with today.
"Adverse childhood experiences are not only at the root of a health crisis in America, they’re also at the root of America’s education crisis. And that’s something that right now, we’re all dealing with the downstream effects, but we’re not getting to the root."
Through addressing and interrupting ACEs as soon as possible, Harris says, the infrastructure of care can change from being reactive to preventive. This would not only improve individual health outcomes, but it would have greater public policy implications:
"Right now we are spending almost three trillion dollars a year on health care and 75% of that is for treatment of chronic disease. Having an Adverse Childhood Experience score of four or more dramatically increases the risk for 7 out of 10 of the leading causes of death in the United States," she notes. "We're spending this money on healthcare, on management of addiction, the opioid crisis - all of these different things and we haven't tackled early adversity as a root of that."
Harris says solutions that can help fight toxic stress response in adults include exercise, good nutrition, mental health care, and healthy relationships. She adds that ideally children should be surrounded by safe, stable, and nurturing adults to help them recover from tolerable stress before it advances to toxic stress and its long-term implications.
However, Harris says, "One of the most important things we can do right now is to make sure all pediatricians in America are screening for ACEs as a part of a routine physical exam. That simple change could make a dramatic different in the life and the outcomes of so many children."
Dr. Nadine Burke Harris will talk about her work Saturday afternoon at Marquette University’s Varsity Theater.