Dec. 16, 2015 | Forbes
By Senator Bill Frist, M.D.
I recently heard a startling statistic. According to a CDC study, children who endure six or more adverse childhood experiences (ACEs) by the age of 18—incidents of abuse or neglect that make a child feel unsafe or unwanted in their home—live on average 20 years less than their peers who are not exposed to these ACEs growing up. Furthermore, those with four or more ACEs are seven times more likely to be alcoholics in adulthood, twice as likely to develop cancer, and sadly, twelve times more likely to commit suicide. They lead sicker, shorter lives. And they often pass those disadvantages on to their own children by recreating the traumatic environments that they grew up in, perpetuating a toxic cycle.
What does a childhood with multiple adverse experiences look like? It could be a girl of divorced parents, whose mother is abusive and suffers from mental illness. It could be a young boy who is being raised by his grandparents because both his parents are addicts and incarcerated. It could be a child whose father committed suicide after years of struggling to make ends meet to feed and clothe his children. These are some of the more troubling cases. But nearly two-thirds of Americans report having one or more ACE, and more than one in five report three or more ACEs. Childhood stressors are increasing the likelihood of illness and addiction for a meaningful portion of the U.S. population–and our healthcare system fails to address this key driver of health.
The science behind adverse childhood experiences dates back to a studythat began in 1995 by Kaiser Permanente and the CDC. The study surveyed 17,000 Kaiser patients regarding childhood abuse, neglect, and exposure to other traumatic stressors, and looked at patient health outcomes. The research found that as exposure to toxic stress in childhood increased, so did the individual’s risk for health problems such as alcoholism, COPD, depression, STDs, adolescent pregnancy, drug and tobacco use, and suicide. Their conclusion has been supported in numerous academic studies and publications, and reinforced by CDC’s continued tracking of the original study participants. Just recently, however, this concept has been gaining traction in policymaking. And rightfully so. It should be central to our conversations about education, child health and community well-being.
In Tennessee, the Haslam Administration is taking meaningful action. Governor Bill Haslam and First Lady Chrissy Haslam launched a three-year initiative this November to make Tennessee the first state in the nation to take a comprehensive public policy approach to addressing adverse childhood experiences. Partnering with the Memphis-based ACE Awareness Foundation, an ACE steering committee will be established to create a series of innovation teams across Tennessee to help communities develop prevention and intervention strategies. The state government assessed the cost of adverse childhood experiences to communities at more than $200,000 per child, with one in five Tennesseans having an ACE score of three or more. We are a state that is ripe for change.
You can take the test here to find your own ACE score. Then go through the questions again, thinking about the children in your life and their circumstances. Do they have a loving home? Are they receiving positive reinforcement? Do they feel safe? There is no doubt that the statistics around adverse childhood experiences are disheartening. However it is important to note is that having a high ACE score doesn’t mean a child is doomed to a miserable, short life. It gives them tougher odds than a child who grows up in a loving, financially stable, two-parent household. But the negative effects can be counteracted by other positive life experiences, such having a strong mentor like a great teacher, supportive pastor or loving grandparent. It could be finding structure and success in activities like sports or music.
The steps Governor and First Lady Haslam are taking in Tennessee are commendable and should be replicated. Strong leadership is crucial to raising awareness on ACEs. But reducing the negative long-term impacts of ACEs will require more than government action. It requires our communities to come together in support of our children and their futures. In your own hometown, you could tutor a disadvantaged youth, coach a team, participate in the Big Brother/Big Sister program, or start a food, clothes or toy drive for struggling families. Improving the health of our nation requires a shift in the way we approach health and well-being. We are trying to address problems in the emergency room when they need to be addressed years earlier around the dinner table, in the neighborhood, and on the playground.
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