How childhood trauma affects health across a lifetime | Nadine Burke Harris | TED

Summary

This script discusses the profound impact of childhood trauma, or Adverse Childhood Experiences (ACEs), on health outcomes throughout life. It reveals the correlation between high ACE scores and increased risks of chronic diseases, mental health issues, and early death. The speaker, Dr. Nadine Harris, emphasizes the need for routine screening and multidisciplinary treatment, advocating for a public health approach to address this widespread yet under-acknowledged issue.

Takeaways

• 🚨 Childhood trauma is a significant public health issue that increases the risk for leading causes of death in the United States.
• 🧠 High doses of childhood trauma can affect brain development, the immune system, hormonal systems, and even DNA transcription.
• 📊 The Adverse Childhood Experiences (ACE) Study revealed a strong correlation between the number of adverse experiences and negative health outcomes later in life.
• 💔 Exposure to severe trauma in childhood can triple the lifetime risk of heart disease and lung cancer and significantly reduce life expectancy.
• 👩‍⚕️ Doctors are currently not trained in routine screening or treatment for the effects of childhood trauma.
• 🏥 The establishment of the Center for Youth Wellness in San Francisco aims to screen, prevent, and heal the impacts of ACEs and toxic stress.
• 📈 The ACE Study showed that 67% of the population had at least one ACE, and 12.6% had four or more, indicating a widespread issue.
• 🔬 Science has begun to explain the biological mechanisms by which early adversity affects the developing brain and body, leading to increased health risks.
• 🏘️ The problem of childhood trauma is not limited to impoverished areas; it affects a broad spectrum of the population.
• 🌟 Recognizing childhood trauma as a public health crisis is crucial for developing effective interventions and treatments.
• 📣 There is a need for greater awareness and action to address the impact of childhood trauma on health, as it is a solvable and preventable issue.

Q & A

What significant discovery was made by the CDC and Kaiser Permanente in the mid-'90s?

The CDC and Kaiser Permanente discovered that childhood trauma significantly increases the risk for seven out of ten leading causes of death in the United States.

How does high-dose exposure to childhood trauma affect an individual's health?

High-dose exposure to childhood trauma can affect brain development, the immune system, hormonal systems, and even the way DNA is read and transcribed, leading to triple the lifetime risk of heart disease and lung cancer, and a 20-year difference in life expectancy.

Why are doctors not routinely trained in screening or treating the effects of childhood trauma?

The effects of childhood trauma have not been traditionally recognized as a medical issue, and thus, medical training does not typically include routine screening or treatment protocols for it.

What is the difference between the type of trauma discussed in the script and common, less severe setbacks like failing a test?

The trauma discussed in the script refers to severe or pervasive threats such as abuse, neglect, or growing up with a parent who has mental illness or substance dependence, which are significantly different from common setbacks like failing a test or losing a game.

What was the speaker's approach to addressing health disparities in Bayview-Hunters Point?

The speaker and California Pacific Medical Center opened a clinic in Bayview-Hunters Point to provide top-quality care regardless of the ability to pay, targeting health disparities such as access to care, immunization rates, and asthma hospitalization rates.

What was the surprising trend the speaker noticed regarding referrals for ADHD?

The speaker noticed that many children referred for ADHD did not actually have the disorder; instead, they had experienced severe trauma, suggesting that something else was going on.

What is the Adverse Childhood Experiences (ACE) Study, and what did it reveal?

The ACE Study was conducted by Dr. Vince Felitti and Dr. Bob Anda, and it revealed a correlation between a person's history of exposure to adverse childhood experiences and their health outcomes later in life, showing a dose-response relationship.

What are some of the common ACEs included in the ACE score?

Common ACEs include physical, emotional, or sexual abuse; physical or emotional neglect; parental mental illness, substance dependence, incarceration; parental separation or divorce; or domestic violence.

How does the hypothalamic–pituitary–adrenal axis play a role in the health effects of childhood trauma?

The hypothalamic–pituitary–adrenal axis is the body's stress response system. Repeated stress activation from childhood trauma can go from being adaptive to maladaptive, affecting the developing immune and hormonal systems and even the way DNA is read and transcribed.

What is the Center for Youth Wellness, and what does it aim to do?

The Center for Youth Wellness was created in San Francisco to prevent, screen, and heal the impacts of ACEs and toxic stress. It focuses on routine screening, multidisciplinary treatment teams, and educating parents about the impacts of ACEs.

Why has the issue of childhood trauma not been taken more seriously in the medical field?

The issue may have been marginalized because it was seen as not applicable to everyone or because it was easier to attribute health outcomes to bad behavior rather than acknowledging the impact of childhood trauma. Additionally, it may require a shift in perspective to view it as a public health crisis.

What does the speaker believe is the most important thing needed to address the issue of childhood trauma?

The speaker believes that the most important thing needed is the courage to acknowledge the reality of the problem and to recognize that it affects everyone, not just certain populations or neighborhoods.