If we are to truly heal from the effects of Covid-19, we need to let medicine guide our decision-making once again and recognize the role of pandemic trauma and its factors. Other cumulative stressors have on individual and community health – especially when experienced in childhood.
In their recent discussions, the US Centers for Disease Control and Prevention rightly noted that the Covid-19 pandemic has resulted in an increase in Harmful childhood experiences (ACE), or potentially traumatic events that are associated with health problems and increased risk for many leading cause of death United States. Unfortunately, most health professionals have yet to incorporate this powerful research into the way we manage care for both children and adults. In fact, too many doctors I’ve talked to still consider ACEs a social problem that doesn’t directly affect health or require medical intervention.
It’s time we change that. The research is clear and if we don’t address the long-term effects of ACEs, I fear our country will have to deal with the lingering effects of Covid-19 for decades to come.
ACEs refer to 10 types of opponents or traumatic events experienced 18 years old, such as a parent’s mental illness, witnessing domestic violence, or growing up in a home with substance abuse. Exposure to these stressors during childhood, with no buffer to deal with, leads to the triggering of a prolonged body stress response. This is called toxic stress response and it is especially harmful to the baby’s brain, immune and hormonal development.
The effects of toxic stress can persist through every stage of our lives. The more ACEs an individual experiences, the more likely they are to develop acute and Chronic diseases, such as asthma, cardiovascular disease, or depression, both in childhood and adulthood. According to a study published in the American Journal of Preventive Medicine in 2009, people with six or more ACEs are expected to live a shorter life 19 years shorter on average than those without ACE.
ACEs have been added value during a pandemic, as well as other risk factors for toxic stress that can damage long-term physical and mental health – like having a loved one die, tens of thousands of children experienced because of Covid-19. And while the pandemic itself is not one of the traditional ACE criteria, it has the potential to lead to toxic stress. For much of the pandemic, we’ve been cut off from everyday supports and social interactions, we need to turn off our body’s stress response. So it’s no surprise that the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association recently announced: national emergency on the mental health of children and young people due to the tremendous adversities and disruptions they have experienced as a result of the pandemic.
Those raised in pre-existing adversarial homes are especially at risk. Community of color has more likely to experience ACE but now they have bear the burden infections and deaths from Covid-19 – as well as economic hardship during the pandemic. This can lead to even higher rates health status, such as cardiovascular disease.
The dramatic increase in ACEs due to Covid-19 is likely to lead to a large wave of consequences that will threaten not only our health care system but also our economy as well as our education and health systems. our criminal justice. ONE research published in early 2020 estimated the annual cost of ACEs in California from just eight health conditions and risk factors at $10.5 billion, with another $102 billion lost in burden of disease, which estimates the cost of premature death and the number of productive life years lost due to disability. According to a 2016 study published in this journal, children with four or more ACEs were significantly less likely to graduate from high school and 3.1 times more likely to be arrested as a juvenile than those with children without ACE, according to a 2016 study published in this journal, Department of Pediatrics. These are all pre-pandemic numbers. We still don’t know how harmful ACEs caused or combined by Covid-19 will be.
But we do know that with the right infrastructure, ACE prevention, screening, and treatment can stop individual distress, as well as persistent societal challenges, before they take root. Toxic stress is can be treated when ACEs are identified early and managed with high quality intervention. Therefore, we need a coordinated, interdisciplinary approach that provides health care providers with the right training and support to effectively and equitably address ACEs.
Here in California, we are making great progress in building our own ACEs infrastructure that I hope the rest of the nation can learn from. As a general surgeon, I have developed a The report to serve as a blueprint for how communities can scale ACE interventions. In January 2020, California launched ACE Aware Initiative and since then, Over 20,000 healthcare providers were trained to screen for ACEs and treat toxic stress with evidence-based interventions. And now, with the recent passage of The ACEs Equity Act, More Californians will have coverage for high-quality ACE screening – an important step forward for our state’s public health.
And that’s just the beginning.
This year California State Budget is investing more than $4 billion over five years to transform youth behavioral health – a unique investment in a generation in health care, education, public safety and ministries. Other parts of our society are suffering because we don’t toxicly treat people with stress. That’s the kind of system-wide policymaking we need at the state and federal levels to eliminate the intersecting and multifaceted effects of ACEs. As our nation strives to rebuild for the better after one of the greatest collective traumas of our time, government leaders must also take a reactive approach to trauma. for policy making.
This country will never fully advance, and never fully recover, if we do not learn the lessons of this pandemic and let medicine take the lead. I would say that Adverse Childhood Experiences do not determine one’s fate. Now is the time to tackle the root of the challenges ahead of us and secure a different fate for ourselves, our children and our country.
