50 Miles from the Freeway: Our ACE Scores

50 Miles from the Freeway is a monthly syndicated column about access to rural healthcare by Linda Stansberry. In 2023 this column will focus on mental health. For more information or to ask questions, visit www.lindastansberry.com.

Let’s start at the beginning. Let’s start with our kids.

In 1998 researchers with Kaiser Permanente conducted a study of 10,000 adults who were getting their annual physical, asking them to fill out confidential surveys about their childhood experiences and current health status and behaviors. What they found is that there is a relationship between childhood trauma to many of the leading causes of death in adults.

This study led to the term ACEs, or Adverse Childhood Experiences, which we now use to describe a spectrum of traumatic events that can occur in childhood, including physical, emotional and sexual abuse, neglect, homelessness, parental mental illness, witnessing domestic abuse, drug and alcohol abuse in the home, divorce, incarcerated family members and bullying. The American Society for the Positive Care of Children has a test you can take online to get your own ACEs score.

Adverse Childhood Experiences have been found to lead to a number of negative health outcomes in adulthood, including higher rates of heart disease, stroke, cancer and diabetes. This is due in part to how these traumatic experiences impact our stress response. Chronic stress spikes adrenaline and cortisol, raising blood pressure, suppressing the immune system and creating a host of other cascading physical impacts. Chronic stress and trauma in childhood has been found to correlate with problems with mental illness, drug use and addiction later in life.

According to a 2014 study done by the California Center on Youth Wellness, Humboldt and Mendocino have some of the highest rates of adverse childhood experiences in California, with one-third of children experiencing four or more ACEs prior to their 18^th birthday. (The only other county to match this score was Butte.) First 5 Humboldt has a summary of this research as well as a call to action on their website, and are one of many local organizations working to implement a statewide initiative with the goal of reducing ACEs and toxic stress by half by 2030.

The pieces of this plan include four major resiliency factors found to combat trauma. They include, as quoted directly from the First Five website:

 

 

• Relationships with other children and adults through interactive activities.
• Safe, equitable, stable, positive school and home environments.
• Sense of connectedness through social and civic activities.

• Opportunities for social-emotional development, including playing with peers, self-reflection, and collaboration in art, physical activity, drama and music.

In Southern Humboldt, our local family resource centers have been working hard to implement many of these principles into their programs, including creating wrap-around programs to support parents so they have access to food, counseling and childcare. But, of course, we need more. Having grown up in Southern Humboldt, I am familiar with the challenges that the sheer distance between my home and other kids’ homes created in being able to interact. Our tiny school districts seem to always be in jeopardy of losing teachers and students due to housing and employment constraints. As for that sense of connectedness, I can only speak for what I’ve seen in my community, but we do have a proud tradition of civicmindedness by necessity, and other traditions as well associated with the particular watersheds we’re from. I have found it hard to explain to some of my friends who grew up in cities, the privilege I feel to be able to go home to the Mattole for the Fourth of July barbecue every year and break bread with people who have literally known me through every stage of my life. That’s community, that’s connectedness. That’s something we can build on.

Awareness of the impact of childhood trauma is one of the first steps in addressing it. The gentlest and most productive way to do this seems to be supporting parents and the institutions that support them. Those would include your family resource centers and by support, of course, I mean money and time. Another important resiliency factor for children is having a supportive adult in their lives. An extra adult – be it a grandparent, aunt, uncle, teacher, coach or neighbor – who can serve as a good role model and person to talk to for children experiencing trauma often makes the difference in whether or not they graduate from school and go on to be healthy adults.

In the five years I worked as a staff writer for the North Coast Journal, I attended a lot of meetings on homelessness. The population of homeless people in California and in our region, has increased substantially over the past two decades. I got to report on a lot of hand-wringing and some kooky ideas about what was causing it and how to address it, including theories that all of the homeless people in Humboldt County were being bussed here from elsewhere and that the best thing to do was just to put them on another bus, or put them all in jail or force them to work. I call those ideas kooky because they’ve all been tried at one time or another and they appear to not to have been effective, otherwise we’d be in a different situation, wouldn’t we?

What I did find as I began talking to people who were living rough, whether it was a new situation for them or they had been homeless for years, is that the common factor in their stories was trauma, those childhood experiences that we call ACEs. And that more often than not, they had grown up in homes (or in group homes, or foster homes) where their parents and guardians had also experienced trauma. And many of them had gone on to have kids of their own, kids who had experienced or were experiencing trauma. That’s the nature of the beast: It’s intergenerational, it’s cyclical, and it’s incredibly complicated. We have very high rates of homelessness, substance abuse, mental illness and other issues in our community and there is no simple or quick solution. It’s a complex problem that may take an entire generation to address. We definitely need to provide adequate healthcare, including mental healthcare, to adults in our community, but we also need to get to the root of the issue. Because most of the people you see experiencing those problems in public aren’t from “somewhere else,” they’re actually from here. They’re someone’s kid. Everybody is someone’s kid, and everybody deserves to grow up feeling safe and supported. How about we start now.