A doctor recounts their experience working with children in a low-income neighborhood in San Francisco, where they noticed a high rate of referrals for ADHD that didn't match the symptoms. After researching, they discovered the Adverse Childhood Experiences (ACE) Study, which found a strong correlation between childhood trauma and increased risk of chronic diseases, mental health issues, and early death.
The study, conducted by Dr. Vince Felitti and Dr. Bob Anda, surveyed 17,500 adults and found that 67% had at least one ACE, and 12.6% had four or more. The doctor explains how ACEs affect brain development, immune system, hormonal systems, and DNA transcription, leading to increased risk of disease.
The doctor emphasizes that childhood trauma is not just a social or mental health issue but a public health crisis. They founded the Center for Youth Wellness to prevent, screen, and heal the impacts of ACEs and toxic stress. They advocate for routine screening, multidisciplinary treatment teams, and education for parents.
The doctor concludes that addressing ACEs requires a movement, and that recognizing the scope and scale of the problem is the first step towards finding solutions. They encourage the audience to have the courage to look at the problem and acknowledge its impact on individuals and society.
Here are the key facts extracted from the text:
1. In the mid-1990s, the CDC and Kaiser Permanente discovered an exposure that increased the risk of seven out of 10 leading causes of death in the United States.
2. The exposure was found to affect brain development, the immune system, hormonal systems, and the way DNA is read and transcribed.
3. High doses of the exposure can triple the lifetime risk of heart disease and lung cancer, and result in a 20-year difference in life expectancy.
4. The exposure is not a pesticide or packaging chemical, but childhood trauma.
5. Childhood trauma can include physical, emotional, or sexual abuse, neglect, parental mental illness, substance dependence, incarceration, parental separation or divorce, and domestic violence.
6. The Adverse Childhood Experiences Study (ACEs) was conducted by Dr. Vince Felitti at Kaiser and Dr. Bob Anda at the CDC.
7. The study involved 17,500 adults and asked about their history of exposure to adverse childhood experiences.
8. For every "yes" to an adverse childhood experience, participants received a point on their ACE score.
9. The study found a dose-response relationship between ACE scores and health outcomes, with higher ACE scores resulting in worse health outcomes.
10. 67% of the population had at least one ACE, and 12.6% had four or more ACEs.
11. A person with an ACE score of four or more had a higher relative risk of chronic obstructive pulmonary disease, hepatitis, depression, and suicidality.
12. A person with an ACE score of seven or more had triple the lifetime risk of lung cancer and three and a half times the risk of ischemic heart disease.
13. The hypothalamic-pituitary-adrenal axis (HPA) is the brain's and body's stress response system, which governs the fight-or-flight response.
14. High doses of adversity can affect the developing immune system, hormonal systems, and the way DNA is read and transcribed.
15. The Center for Youth Wellness in San Francisco was created to prevent, screen, and heal the impacts of ACEs and toxic stress.
16. Routine screening for ACEs is not a standard practice in healthcare.
17. The original ACEs study was conducted in a population that was 70% Caucasian and 70% college-educated.
18. Adverse childhood experiences are the single greatest unaddressed public health threat facing the United States today, according to Dr. Robert Block, former President of the American Academy of Pediatrics.