By Karla Cloete
Edited by Tasmiyah Randeree
A surprising new study has found that childhood traumas can severely affect health outcomes in adulthood.
From 1995-1997 a group of researchers at Kaiser Permanente performed physical exams on 17,000 patients and surveyed their major childhood traumas and current health-related behaviours.
Their study found a strong link between exposure to abuse and family dysfunction and risk factors for early death in adulthood. In their study, they found that patients who had experienced 4 or more of the surveyed traumas were more likely to suffer from alcoholism, drug abuse, and depression. They were also more likely to be obese, have diabetes, or be diagnosed with liver diseases.
When Nadine Burke Harris, an American paediatrician, began working in an underserved district of San Francisco she noticed how many of her patients had experienced childhood trauma, but were misdiagnosed mistakenly with ADHD. She began digging into the link between trauma and well-being:
"[B]efore I did my residency, I did a master's degree in public health, and one of the things that they teach you in public health school is that if you're a doctor and you see 100 kids that all drink from the same well and 98 of them develop diarrhea, you can go ahead and write that prescription for dose after dose after dose of antibiotics. Or you can walk over and say, 'What the hell is in this well?'
"So I began reading everything that I could get my hands on about how exposure to adversity affects the developing brains and bodies of children."
What are ACE’s and why do they matter?
Adverse childhood experiences or ACEs are traumatic experiences undergone during childhood which could be anything from domestic violence, death or separation from a parent/family member, childhood neglect or a caregiver struggling with mental health issues.
ACEs aren’t only a psychological issue. Research has found that traumatic experiences in childhood can affect us as adults in our education, careers, and relationships and increase the risk of suicide. They are also linked to toxic stress which permanently alters brain development, affecting a person’s stress response, and ability to make decisions, learn and pay attention. ACEs also impact one’s sexual and reproductive health and increase the risk of STIs, teen pregnancy and risk of being sexually trafficked.
One might look at all these findings and shrug them off. “People with bad childhoods pick up unhealthy habits or do unhealthy things to cope,” you might say to yourself. But according to studies that adjusted for high-risk behaviours (drug use, binge eating and drinking, smoking, etc.), the health outcomes were still poor when it came to ACEs.
The answer lies in the hypothalamic-pituitary-adrenal axis - our body’s stress response system. When we are under severe stress our bodies mobilize their emergency responses by releasing various hormones, including adrenaline and cortisol. This system is highly effective, but when we live in this aroused state or enter into it too often, this protective mechanism can do more harm than good.
Children’s brains and bodies are still developing so they are very sensitive to these reactions which negatively impact the structure of their brain, their immune response and hormonal systems.
Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today," says a former President of the American Academy of Pediatrics, Dr. Robert Block.
ACEs don’t only affect individuals and their families, but also cost governments and their economies billions of dollars every year. Difficulties in school and the workplace later in life, increased health care costs, job loss and loss of wages due to illness can be economically devastating. By eliminating ACEs, we could prevent 1.9 million cases of heart disease and 21 million cases of depression in adulthood.
What can be done?
Strong relationships with caregivers who are nurturing, and consistent, and create a safe home environment for children are essential to mitigating the impact of trauma, as well as preventing these traumas altogether.
According to the Mayo Clinic, the effect of ACEs can be combatted by increasing a child’s ability to cope and their overall resilience. Support such as positive parenting practices, community relationships and resources, and a protective network of social connections can all mitigate the effects of these traumas. Children who have a sense of purpose, the ability to self-regulate, and good emotional health will also be more resilient to their ACEs.
In a much broader sense, ACEs shouldn’t just be mitigated but prevented altogether through family economic support and financial security, family-friendly workplace policies, and maternal employment. Protections against violence, increasing community support while decreasing poverty and early education initiatives that promote coping skills in children and safe discipline and parental guidelines can all decrease ACEs.
ACEs don’t have to spell doom and disaster. When used and screened for, this data can better inform health care practices and screening. Ideally, health care practitioners should screen both children and adults for exposure to ACEs and use this information to better inform their assessments and recommendations. Doctors should be aware of a history of trauma when treating their patients because these individuals can be more susceptible to conditions like diabetes, heart disease and even cancer.
Trauma-informed therapeutic interventions can also benefit both children and adults at any point in time and can significantly improve the harm and decrease mental health issues related to trauma such as PTSD, anxiety and depression.
Individuals who are concerned about their ACE scores can also be aware of their own increased risk factors and seek out preventative care and advocate for their own health and well-being. If we use data correctly it can be a positive force to affect change and can empower us as individuals.
For resources on how to access South African mental health care services and safe spaces to find support click this link. You can also learn more and watch Nadine Burke Harris’s Ted Talk here.
Resources
https://www.ajpmonline.org/article/S0749-3797(98)00017-8/fulltext
CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Fabout.html
https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime
https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdf