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Adverse Childhood Experiences a priority of county health officials

By Marissa Harshman, Columbian Health Reporter
Published: April 11, 2016, 6:00am

Throughout her childhood, Delena Meyer encountered social and human services from every angle.

She’s the daughter of an addict who died from AIDS. She went through child protective services and the foster care system. She was a teen mom who gave up a child for adoption. She married, and divorced, young. She was a single mom. And she struggled with emotional issues.

She was on the “stereotypical trajectory of a troubled life,” she said.

But eight years ago, Meyer learned that she wasn’t the only one touched by Adverse Childhood Experiences, or ACEs. Far from it.

Research shows 62 percent of adults have at least one such traumatic experience. About 42 percent of Washington high schoolers have three or more.

“It’s not just some of us,” Meyer said. “It’s all of us. It’s just a matter of flavor and degree.”

Clark County Public Health has taken notice of the impact of ACEs and made it a top priority. Meyer has joined the department’s efforts, becoming a part of the ACEs Action Alliance dedicated to creating a trauma-informed, resilient community.

“Public health made it not just a focus but the No. 1 health priority because there is not an area that it doesn’t touch,” Meyer said.

Long-term impacts

Adverse Childhood Experiences are potentially traumatic events that occur before age 18 and impact long-term mental and physical health. Examples of ACEs include emotional, physical or sexual abuse; physical or emotional neglect; loss of a parent due to divorce, death or incarceration; living with a mentally ill or drug- or alcohol-addicted family member; or being exposed to violence.

A groundbreaking study in 1985, the ACE Study, followed 17,000 Kaiser Permanente patients in San Diego. The study showed that exposure to ACEs can increase the risk of a variety of physical, mental and behavioral problems later in life, including teen pregnancy, alcoholism and drug abuse, depression, heart and liver disease, multiple sexual partners, sexually transmitted diseases, intimate partner violence, suicide attempts and unintended pregnancies.

The study found that those with four or more ACEs — deemed a “high” ACE score — compared with those who have no ACEs, are seven times more likely to be alcoholic; seven times as likely to have sex before age 15; and twice as likely to be diagnosed with cancer.

The study not only revealed the prevalence of adverse childhood experiences but also the multi-generational impact of ACEs. Parents with two or more ACEs were found to be eight times more likely to have conditions that create ACEs for their own children, according to the study.

The study, for the first time, provided a “clear and undeniable link between childhood trauma and health risk factors, chronic disease and mental illness,” said Cyndie Meyer, program manager with Clark County Public Health.

One thing the study did not do, however, was explain why those traumatic experiences had such a profound impact. But, in the years since, additional research has shed light on that connection.

Toll on brain

Childhood exposure to traumatic events impacts neurodevelopment, which leads to social-emotional and cognitive adaptations. Those adaptations lead to the risk factors for disease, disability and social problems.

For example, when a child is living in fear, his survival mechanism will take over, flooding his brain with cortisol and adrenaline, Cyndie Meyer said. The cortisol and adrenaline alter brain development, she said.

Likewise, if a child is neglected or not stimulated, certain areas of his brain don’t develop normally, Cyndie Meyer said. If a healthy child’s brain pathways resemble a full, spring tree with lots of branches, a neglected child’s brain looks more like a bare, winter tree, said Joan Caley, a member of the ACEs Action Alliance.

But just because a child is exposed to traumatic events, even numerous ACEs, that does not mean he or she is destined to be plagued by emotional and behavioral issues, chronic illness and early death, Cyndie Meyer said.

“Just one strong, caring relationship with an adult can counter that,” she said.

And that’s an important piece of public health’s work — not only preventing ACEs but mitigating the impact on the multiple generations of adults living with high ACE scores.

The Community Foundation for Southwest Washington awarded Clark County Public Health a three-year grant — $50,000 for each of the three years — for ACEs prevention work in Battle Ground. Ultimately, health officials hope to extend efforts to the rest of the community, Cyndie Meyer said.

In February, public health hosted a training session on ACEs for 200 school district employees from two Battle Ground schools. The district plans to conduct the training at all of its other schools in the next year, Cyndie Meyer said.

Working with partners

Health officials are also working with medical providers, faith groups, the police force and businesses in Battle Ground. The pilot project will train medical providers to screen for ACEs and business owners how to become trauma-informed organizations. The Battle Ground Police Department has already trained its officers in ACEs and how they impact brain development.

The goal with the project, Caley said, is to identify the available resources in the community and the gaps that need to be addressed.

“We don’t have everything we need in this community right now,” she said.

One area that needs work is supporting parents once they are informed about ACEs, said Delena Meyer.

“It is absolutely traumatizing to tell a person what their childhood has done to them and not give them the resources to mitigate and minimize that,” she said.

Delena Meyer was 28 years old when she learned about ACEs. For the first time, she was able to differentiate between life situations that were the result of her decisions and those caused by the decisions of others.

“I no longer felt ashamed for things that were not my choices,” Delena Meyer said.

Instead, she was able to move on from the things she couldn’t control and take ownership of the things she could.

“I had the epiphany, I wasn’t crazy and I wasn’t broken,” Delena Meyer said. “My brain had unequivocally been affected.”

“I had already beaten the odds for people like me,” she added. “It showed me that everyone is like me. It took away the otherness.”

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Columbian Health Reporter