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CA ACEs Summit: Overall health depends on much more than healthcare, pediatricians and other public health specialists agree

Dr. Dayna Long and Barry FinestoneKenneth Epstein

Karen Hill, PhD of the Center for Youth Wellness moderated the health sector discussion of the agenda topic “Building the Foundation to Help Children Thrive.”  On the panel were two pediatricians (Elisa Nicholas, MD, MSPH of The Children’s Clinic of Long Beach and Dayna Long, MD, FAPP of the Children’s Hospital Oakland), Kenneth Epstein, PhD of the San Francisco Public Health Department and Wendie Skala of Kaiser Permanente. 


Here are some of the highlights of the discussion:


---To prepare the 9,000-member workforce of the SF Department of Public Health to implement practices that reflect an understanding of the impact of trauma, Epstein stressed the importance of good communication, embedding champions throughout the department, and recognizing that systems are traumatized as well as individuals. So far, 1,000 individuals have been trained.


---Nicholas described the challenges of providing services to a diverse population, some who have experienced significant trauma such as immigrants from Cambodia. Priorities are screening patients, developing strategies to address the needs of patients at high risk (i.e., those with ACE scores of 4 or higher), and recognizing protective factors such as social connections and parenting knowledge.  She described the Clinic’s participation in the National Council’s Learning Community for trauma-informed systems that resulted in the training of 340 individuals.


---Skala is a trauma prevention coordinator for Kaiser Permanente in south Sacramento, a community characterized by high levels of interpersonal and community violence, high infant mortality and reduced life spans.  One program connects trauma specialists with kids who are hospitalized as the result of violence, a time when a caring adult can impact their lives. The community also has had success in adapting the LA Summer Night Lights program for an area called Mack Road in south Sacramento.


---Long presented startling statistics about the health status of individuals in Oakland, comparing low-income areas with more affluent areas.  There is a 14-year difference in life expectancy between 

Dr. Felitti and Dr. McCaw

the lowest and highest income areas as well as major differences in birth weight, reading at grade lev

el and incidence of stroke. A consortium has been established—the Bay Area Regional Help Desk—to address basic needs such as food and housing. About 400 navigators help clients if they have problems related to housing or food insecurity. One program that is part of redefining health is called “Let’s Talk about….” It encourages parents and other caregivers to talk to children about day-to-day topics to engage them and help bridge the word gap that exists in these disadvantaged communities. T-shirts, billboards, posters in bus shelters help educate the public about this initiative. 




Images (3)
  • Dr. Felitti and Dr. McCaw: Dr. Felitti (left) and Brigid McCaw of Kaiser Permanente (right)
  • Dr. Dayna Long and Barry Finestone
  • Kenneth Epstein: Networking after the health session

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