Did your last checkup include discussions of stressors such as physical, emotional and sexual abuse, violence, mental illness or substance abuse in the home, divorce or the incarceration of a family member? If California’s new Surgeon General Nadine Burke Harris, M.D., has her way, your next one will.
Our state’s first surgeon general, Burke Harris, a Bay Area pediatrician and founder of the Center for Youth Wellness, has devoted much of her career to studying and addressing the impact of these issues, also known as Adverse Childhood Experiences, or ACEs. Although they take place during childhood, the toxic stress that ACEs create can result in lifelong health problems, including chronic obesity, diabetes, heart disease, depression and increased risk of substance abuse and suicide.
Her plan to address ACEs begins with raising awareness among the general public and throughout the healthcare system. “Whether you’re a cardiologist or a pediatrician or a brain-science researcher, there’s a critical role that folks across the healthcare system can play in advancing the science of ACEs and toxic stress,” she says. She also advocates for routine use of ACEs screening tools – generally in the form of a questionnaire – already in use by many providers across the country.
Despite the high rates of ACEs – the National Survey of Children’s Health reported that nearly a third of U.S. kids ages 12-17 have experienced two or more types of childhood adversity – Burke Harris has a positive message for parents. “We’re now understanding more than we ever have before about how the relationships and environments that children experience make a difference in their lifelong health,” she says. “That means that we as parents can have this incredible opportunity to shape the health of the next generation.”
Awareness is the first step. The second is to immerse your child as much as possible in safe, stable, nurturing relationships and environments, which can protect their health even when ACEs are present. Supporting healthy sleep patterns, exercise, nutrition, mindfulness and mental health is the key to prevention. “The hope here is to implement supportive systems before we see symptoms in kids,” Burke Harris says. “ACEs increase the risk of negative health and developmental outcomes, but they don’t have to. ACEs are not destiny.”
Another thing you can do? Consider your own childhood, because the impact of ACEs can be handed down. Burke Harris says the best way to prevent that is to make sure you have the tools and supportive resources you need to cope with the fallout from your own childhood experiences. “Talk to your doctor about your ACEs,” she urges. “It may be that you can ask for a referral to a mental-health provider or to a health practitioner who can help support you.”
You might need to recognize that, because of your past experiences, your stress response is a little overactive. Your healthcare provider can help you create tools to address that, including things like check-ins with a trusted friend, a workout routine or mindfulness techniques. “When I recognize that this is what’s going on with me, I have my go-to tool box, so I don’t feel overwhelmed,” Burke Harris says, adding that as a mom of four boys, “having those systems of support is absolutely crucial.”
She also reassures parents that there is a silver lining to these toxic experiences. “They’re often the source of our superpowers,” she explains. “For many folks, the challenges that they experienced in their own childhood are really big motivators to them to want to do things differently. That motivation, combined with the awareness and tools and support, can make a huge difference for the next generation.”