ACEs in the Era of Inequality and AGEs
To reduce adverse childhood experiences and build healthy communities, we must address inequality in the context of adverse global experiences
Abstract
Adverse childhood experiences, or ACEs, affect a diversity of health outcomes from substance use to cardiovascular disease. We now understand some of the biologic pathways that translate this trauma into poor health, and exciting work to link this research with community improvement efforts forms the NEAR sciences: Neuroscience, Epigenetics, ACEs, and Resilience. A separate and substantial body of research has found wealth inequality to strongly and adversely affect a comparably wide range of health outcomes, including child well-being; it could be argued that inequality is upstream of ACEs. Finally, overwhelming evidence spanning the breadth of scientific inquiry shows how human activity threatens planetary health in what might be called “adverse global experiences,” or AGEs. We have a unique opportunity to make explicit the links between individual and global health. To improve the health of all we must address ACEs and AGEs and everything in between. Such a monumental task will only be achieved when we succeed in an even larger one—a sea change in our collective vision. Herein lies hope. That sea change may be so intrinsically appealing that its adoption may surprise us with its speed.
Introduction
“The health of the individual cannot be separated from the health of the family, the community and the world.” —the real Dr. Hunter Patch Adams
10 years into my medical career I took a 2-day training on the NEAR sciences: Neuroscience, Epigenetics, Adverse Childhood Experiences (ACEs), and Resilience. I’ve since shared this with audiences from physicians to teachers to parents struggling with their own ACEs. There is now tremendous hope around reducing ACEs and mitigating their effects through resilience research and interventions. Yet the data shows that childhood adversity is increasing.[1] Correspondingly, US mortality, already worse than in 35 other nations, has increased for 3 consecutive years, unprecedented in modern history.[2] Why is this happening?
The answer is complex. It carries us beyond the scope, as large a scope as it is...
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