ACEs, Resilience, and HOPE
What can we do as a community to collectively respond to the burden of adversity and promote positive experiences for all who call Humboldt home?
Twenty years ago, researchers released a study which fundamentally changed the way we understand disease and public health. They questioned almost 10,000 adults about their Adverse Childhood Experiences (ACES) and compared that data to the health outcomes of those who responded. They found that those with more ACES had significantly increased likelihood of experiencing mental illness, substance use disorder, cardiovascular disease, cancer, diabetes, as well as many other less than desirable health and well-being outcomes. We now know that the toxic stress experienced by children leads to changes in a child’s development–helping them to adapt to the stressful environment, but also turning on their stress response system in ways that can lead to long term negative health outcomes.
Expanded View of ACEs
The Kaiser patients from the original ACE Study represented a well-educated and moderately well-off participant pool because they were all patients with private medical insurance. Many researchers now recognize that this left out other factors that cause childhood trauma such as poverty, racial or other discrimination, inter-generational or historical trauma, and neighborhood violence. Additionally, changes to the environment brought on by climate change significantly impact the levels of stress facing communities, children and families. More and more, these three realms are being considered in conversations about ACEs.
ACEs in Humboldt
Humboldt County is one of two counties that share the highest rate in California of residents who report an ACE score of 4 or more, according to the report, “Hidden Crisis: Findings on Adverse Childhood Experiences in California,” by the California Center on Youth Wellness.
What Can We Do
Focus on Prevention
Our community, our services and our policymakers need to invest in prevention. While our services must continue to provide intervention for domestic violence, child abuse and neglect and treatment for mental illness and substance use disorder, we must look at services that have been shown to PREVENT child abuse and neglect. Child abuse and neglect account for 5 out of the 10 ACES indicators. Family strengthening strategies, home visiting, parent education, and family support services have all been linked to prevention of child abuse and neglect.
Become Trauma-Informed/Trauma-Responsive
Trauma-informed care begins with curiosity and empathy about a person’s life experiences. Instead of seeing a person’s behavior as the root problem, we are invited instead to see behavior both as symptom and communication. Rather than asking, “What’s wrong with you?” we ask “What happened to you?”
The phrase trauma-informed care (or trauma-specific interventions) typically refers to evidence-based and best practice models proven to facilitate recovery from trauma, including assessments, treatments, and recovery supports. Trauma-specific interventions directly address the actual consequences of trauma and facilitate trauma recovery. They connect a person’s behavior to their trauma response rather than isolating their actions to the current circumstances alone.
Given the myriad ways that the effects of trauma can vary by age, gender identity, culture, race, ethnicity, and prior history, recommendations have been expressed about expanding this definition to include interventions supported by practice-based evidence—e.g., sources of healing that have demonstrated positive results in particular contexts and communities, without yet being verified by academic research. Ultimately, any successful intervention will reflect an abiding commitment to mutuality and compassion.
(Terms as defined by Trauma and Resiliency: A Systems Change Approach, 2017)
ACEs Aware in California
In January 2020, California launched the first-in-the-nation ACEs Aware Initiative led by the Department of Health Care Services (DHCS) and the Office of the California Surgeon General (CA-OSG). This initiative aims to inform and empower primary care clinicians on recognizing and responding to ACEs and toxic stress, and to strengthen provider engagement and capacity through coordinated trauma-informed systems of care.
“We have set a bold goal to cut ACEs and toxic stress in half in one generation. I believe that we can get there with shared vision, shared understanding, and cross-sector collaboration.”
– Former California Surgeon General Dr. Nadine Burke Harris
- ACEs Aware Roadmap for Resilience, December 2020
- ACEs Aware Trauma-Informed Network of Care Roadmap, June 2021
Promote & Build Resilience in Children, Families, and Communities
The HOPE Model
(Healthy Outcomes from Positive Experiences)
Research has been clear that the most effective buffers to toxic stress are positive relationships. Tufts Medical Center has articulated a model that melds the science of adversity with the science of resilience: Healthy Outcomes from Positive Experiences (HOPE). The HOPE Model, introduced in a 2017 report, “Balancing Adverse Childhood Experiences (ACEs) With HOPE: New Insights into the Role of Positive Experience on Child and Family Development,” presents evidence to support the ability of positive childhood experiences to foster healthy childhood development and mitigate the impact of adversity.
The four building blocks of the HOPE model are:
- Relationships with other children and adults through interactive activities
- Safe, equitable, stable, positive school and home environments
- Sense of connectedness through social and civic activities
- Opportunities for social emotional development, including playing with peers, self-reflection, and collaboration in art, physical activity, drama and music
Every person in Humboldt County needs to understand what ACES are and how they can make a difference. Resilience science offers a pathway for supporting children who experience toxic stress. Caring adults can be the buffers who can help make toxic stress tolerable and less likely to result in lifelong negative outcomes. As a community we need to all understand how we can make a difference. It will take all of us working together to change this cycle. You can be the one to make a difference. Together we can create a healthy future for our children.
First 5 Humboldt is committed to building awareness around ACEs and resilience, while recognizing the powerful impact of positive childhood experiences.
Together with community partners, we work to provide opportunities for education and conversation, and to promote engaging opportunities for caregivers to connect with their children. Visit our For Families page for events in your community!
First 5 Humboldt offers free trainings and workshops to schools, organizations, agencies, and to the community. To request a training, please email first5humboldt@co.humboldt.ca.us or call us at 707-445-7389.
First 5 Humboldt offers trainings on Adverse Childhood Experiences, the impacts of stress on the developing brain and body, and how to support children and families in building resilience. These trainings are offered by request and are designed to be tailored to meet the needs of various audiences, including schools, community organizations, early childhood, and healthcare.
The Community Resiliency Model through the Trauma Resource Institute trains community members to not only help themselves but to help others within their wider social and work network. The primary focus of this skills-based, stabilization program is to re-set the natural balance of the nervous system. CRM’s goal is to help to create “trauma-informed” and “resiliency-focused” communities that share a common understanding of the impact of trauma and chronic stress on the nervous system and how resiliency can be restored or increased using this skills-based approach.
These trainings are offered by request and are designed as a 2-hour CRM Introduction with the option of a second 2-hour CRM Part 2.