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Prevalence of Shasta County Residents’ Early Trauma Explains High ACEs Scores; Hope Remains

 

From ANewsCafe: https://anewscafe.com/2022/08/...cores-hope-remains0/

Editor’s note: Today’s article was written by Eythana Miller as part of the California Humanities Emerging Journalist Fellowship program in collaboration with Shasta Community College and the Shasta College Foundation. Welcome, Eythana Miller, to A News Cafe.

A 3-year-old boy stood in a parking lot in downtown Redding in 2018, throwing rocks at his unconscious, overdosing mother in an attempt to wake her. He was picked up by Child Protective Services and placed into the custody of his father, who had previously been drug-addicted as well, and would relapse several more times.

In 2009, a girl was born in Cottonwood with many physical deformities. Over the years, these birth defects required 15 surgeries which were often painful and costly. The recovery processes and chronic discomfort were challenging on their own, but any time she behaved in a way he deemed disrespectful or displeasing, her father felt that violent physical discipline was appropriate and would strike her repeatedly in the face.

Two siblings ages 9 and 7 who lived in the south of Redding were sold in 2017 to fund their mother’s drug addiction after their father overdosed. His body was in their home for three days before it was removed. After the children were sold, they were held for a month before a family member called law enforcement and the siblings were taken to safety.

Sobering numbers

These children’s stories represent just a few out of thousands who are currently living through scenarios like these or coping with their lasting impact, ranging from the neglect of physical needs to sexual abuse. In California, an estimated 16.7% of adults have lived through 4 or more incidents of trauma before the age of 18, and in Shasta County’s population that number is a staggering 38.8%.

There are several factors that might contribute to the disproportionately high rates in our rural community, including difficulty of accessing social support services, healthcare, and care coordination, but there may be another component to consider. Trauma and abuse tend to be cyclical. When left unaddressed, they too often form generational patterns that families continue living out for many years. This isn’t just because of habits being formed, however. When high levels of toxic stress are sustained for long periods of time, brain development is affected, changing how one responds to similar situations in the future, creating pathways that lead to negative behavior. Toxic stress has also been shown to invoke changes in genetic expressions which are then passed on to the next generation.

Marianne S.

The children mentioned above are a few of those who Marianne S., who declined to share her last name, has worked with in her 13 years as director of the Shasta Family YMCA’s after school care at Boulder Creek Elementary and other related programs. Marianne grew up in Cottonwood. She suffered sexual abuse for five years as a child, in addition to food insecurity, emotional neglect, and being forced to care for her own siblings due to lack of ability from her own parents. As she entered adolescence, Marianne says, “I was very self destructive. Experimenting with alcohol, drugs, substances and sex. . . trying to cope with the trauma because when I came out and asked for help—I spent my seventh and eighth grade year in special ed because nobody believed me.”

A few positive people stood out, however. For example, a school board member and 4H coordinator in Marianne’s life noticed the neglect and abuse she was experiencing, and made it a point to be caring and trustworthy. Marianne reflects, “She showed me what it looks like to have somebody who was safe to be around.”

A high school counselor, upon learning that Marianne was dyslexic, enrolled the girl in welding, band, woodshop, and any other program that could engage her in a way that worked with her particular challenges.

“If it wasn’t for that,” she says, “I probably would have been a statistic as a high school dropout.”

These adults changed things because of their intention and compassion, and eventually became a model of what Marianne could be for other children.

“All of these, what they call ‘non-essential classes’ now, really got me through high school and got me around adults that cared that I showed up the next day. And some days I didn’t. But those were the people who would call and say ‘where is she? What is she doing?’”

During and after high school Marianne struggled with depression, self harm, and drug use, but was ultimately able to go in a better direction, in large part due to the interruptions in the cycle of abuse executed by those caring adults in her life. Many are not so fortunate.

The stigma long associated with openly discussing subjects like these has significantly diminished in the last few decades. People have been more forthcoming than ever with stories of how historical trauma and pain have caused the conditions or mental health struggles that they live with today, such as anxiety and depression. What is strikingly absent in this conversational space is an understanding of how far-reaching the effects of such childhood adversity really are. We’ve begun to uncover the scope of the impact that early circumstances have later in life, and the area we’ve ignored is one that may carry the most catastrophic consequences—our physical health.

From 1995-97, Kaiser Permanente and the Centers for Disease Control and Prevention conducted a study in which they surveyed nearly 10,000 participants, whose medical history they were already familiar with, on the number of adverse childhood experiences (ACEs) they’d experienced before the age of 18. What qualifies as an ACE includes things like physical and emotional abuse, neglect, losing a parent, divorce, as well as dysfunctional home environments like those with drug-abusing parents or domestic violence, totaling 10 questions. The total number of occurrences in one’s childhood and adolescence equals what they called an ACEs score, the term we still use today. This questionnaire has become the standard way of measuring the extent of one’s childhood adversity.

The results of the study were unexpected and disruptive, illustrating for the first time the link between that early adversity and physical health outcomes. They found that people with four or more ACEs are over four times more likely to have chronic obstructive pulmonary disease, two times more likely to be obese, and three times more likely to have a stroke, to name just a few unfortunate realities. Illegal drug use and smoking were also much higher proportionately in those with four or more ACEs. A later study in 2009 found that people who have six or more ACEs died nearly 20 years earlier than those with none. This was a crucial step in validating the reach of early adversity beyond the potential for negative mental health effects, which were understood more widely earlier on. The other finding that took researchers by surprise is how prevalent ACEs are. They were present in every income bracket, ethnicity, and gender. There is some variance between demographics, but the numbers are clear that there is no one group or socio-economic category that suffers from ACEs exclusively.

This knowledge changes the landscape for how we think about early trauma, from the occasional anecdote, to a pressing public health concern that cannot be ignored. The continuation of ACEs means that hundreds of thousands of children are being impacted every day in ways that are harmful to them now and corrosive to their futures. In a later discussion of the original study, Dr. Vincent J. Felitti, who headed the original ACEs work, said, “Adverse childhood experiences are both common and destructive. This combination makes them one of the most important, if not the most important, determinants of the health and well-being of the nation.”

The treatment and care of the many ailments caused by ACEs also generates massive public health expenses that taxpayers are shouldering, estimated to be $112.5 billion annually in California alone.

Michael Burke

Michael Burke is one of the many in Shasta County who has pressed forward in pursuit of tangible change for the families in our region. In 2019 he became the executive director of the local child abuse prevention council that was established in 1983, renaming it Pathways to Hope for Children to focus on the mission for which he he advocates. His many years of experience have shown him a common response when introducing people to this framework of thinking about their own experiences. He says people tend to “minimize and rationalize when someone asks [them] about [their] ACE score.”

In Shasta County, even with scores being as high as they are, it’s important to take into consideration the questions that aren’t being asked; the numbers may be even more severe than what’s been reported. Burke highlights that the “ACEs [questionnaire] doesn’t count cumulative events, pandemics—or fires, which are huge for our county.”

Each year, some families are displaced or even lose their homes, children are unable to play outside because of toxic levels of smoke, and the state of crisis is felt by all. It’s undeniable that this recurring collective catastrophe has an effect on the young people in our region.

Burke has been instrumental in emphasizing the research on the efficacy of hope as a way of mitigating the negative effects of ACEs and bringing a brighter perspective to a field that can be disheartening to investigate. Here “hope” is defined as the belief that your future will be better than your present and you have the power to make it so. Chan Hellman of the University of Oklahoma has learned through his research that hope is a “way of thinking.” Because of this, he says, “it is something that can be taught.”

It’s been shown that hope can be altered through future-oriented goal setting. When those in difficult circumstances don’t have a vision of how their future could be different, behavior often becomes cyclical and they reach for coping mechanisms that ease the pain of hopelessness.

Dr. Fellitti writes about the challenges of intervening in these cycles, stating that intervention will require “an effective understanding of the behavioral coping devices that commonly are adopted to reduce the emotional impact of these experiences. The improbability of giving up an immediate ‘solution’ in return for a nebulous long term health benefit has thwarted many well-intended preventive efforts.”

He goes on to explain that “these problems are both painful to recognize and difficult to cope with. Most physicians would far rather deal with traditional organic disease. Certainly, it is easier to do so, but that approach also leads to troubling treatment failure and to the frustration of expensive diagnostic quandaries where everything is ruled out but nothing is ruled in.”

It’s time to turn to something that works, and the science behind hope and the evidence-based programs that have utilized it confirm that it is where our attention should be.

At Pathways to Hope, Burke and his team have trained 200 people as Hope Navigators, including 80 within the Shasta County Office of Education. They’re equipped to work with families to create goals that can be broken down into actionable steps that each individual has the ability to complete. Through these methods, Burke says, “you break the cycle of abuse and help people get out of it.” Wendy Dickens, director of First 5 Shasta, shares that the other ingredient which influences whether change happens is human connection: “having and building ones that are healthy. At the crux of every program that has success is a relationship.”

It often takes someone who can point you in the right direction and offer their arm along the way. Dickens says, “Individual action is still considered to be the biggest way to pull people out of their issues, when we know it’s not that. It’s social connectivity [and] community support.”

Marianne and others like her are testaments to how it makes a difference to have just a few people who will intervene and advocate. The adults who stopped and intentionally engaged with Marianne taught her to take on tasks. She says, “[These] really helped build my self esteem, which led me to a lot of the leadership roles that I’m in now.”

She learned the importance of taking agency and participating in something bigger than her.

Wendy Dickens

Successful, future-oriented goal setting is a skill that can be learned from a young age, but it is often missed. Discussing why this may happen in lower economic brackets specifically, professor of Early Childhood Education at Shasta College Kate Ashbey says, “It’s not the lack of money necessarily, it’s the ways that poverty affects stress levels and capabilities of the parent. Something that these children often lack is executive functions, but they can be learned.”

Executive functions like emotional regulation, task initiation, and time management hugely affect how future-focused an individual is, and while there’s nothing irreparable about lacking these, we do see the effects carry on throughout one’s life if there is no intervention or personal effort made to learn those missing skills. Ashbey explains the added challenge of not having a safety net when facing obstacles, saying it’s the “piling on of adversity that diminishes capacity. Everyone runs up against setbacks.” The team at Pathways to Hope is meeting families in Shasta County where they are to help them create clear avenues for how to move forward.

One of many things that Pathways to Hope works on for the good of the county is Camp Hope.

Camp Hope 2021

Children that take part in Camp HOPE, experience an evidence-based curriculum that is designed specifically to help them navigate their way to violence-free and abuse-free futures. The focus of the lessons, activities and campfires are to help children believe in themselves, believe in each other and believe in their dreams.”

Camp Hope 2021

Camp counselors are trauma-informed young adults ages 18-26 who create a solid bond with the camper. After camp, youth will have the opportunity to visit the Anderson Teen Center daily, take part in monthly group mentoring activities with their camp counselors and be offered in-home case management for the whole family.

Camp Hope 2021

Another intervention method that can be employed is connecting children directly to tools that will help them process difficult things while holding onto hope. Dave Hill, founder of the social-emotional learning curriculum HeartSmart, advocates for the necessity of embedding resources into school. The universal access that schools provide enables us to share principles and ideas with children in a way that might otherwise be stigmatized; no one wants to be the kid with the special, extra program to attend. By building lessons about hope, love, and perseverance into an elementary school day, children are given the opportunity to cultivate foundational truths that will help them on the journey of understanding and processing what has happened to them, and how they can cope with future experiences. Hill believes “a trauma-informed classroom looks like a nurturing family.”

In a perfect world, we wouldn’t need curriculum on receiving love and holding onto hope, because those lessons would be imparted in a stable home environment. Unfortunate realities beg for these additions, however, and Hill has worked to create a resource that intends to change the culture of the classroom, rather than simply giving children another course to sit through and memorize. In order for kids to effectively learn, we “need to remove fear from the classroom,” says Hill, and giving teachers the tools they can implement is the first step.

Marianne believes the mark is often missed with how the county connects to the people who need the help offered, saying, “These families are not going to the same media source. You have to reach them where they are.”

She contends that we should be sending information home with kids, starting in kindergarten, on how to get access to food, clothing, counseling, and parenting assistance, in language they can understand. She adds, “The resources are out there; the messaging sucks.”

Data can only give us the large picture; it’s not a personal horoscope. Scores do not determine one’s destiny. Dickens shares that in her years working in child welfare, when speaking to people who began to accept responsibility for past actions in order to change, she would ask of the information they were just learning, “Did you know that back then?” She believes it’s important to remind them that “we do the best we can with the info we have. You know more than you did yesterday, so you’ll make different choices now.”

Ashbey summarizes the ACEs research’s essential message in saying, simply, “Early experiences matter.” These could trigger predispositions for conditions like diabetes, heart disease, cancer, and influence behaviors like intravenous drug use and smoking. While these are serious claims, intervention changes those results; community involvement and our chosen behaviors still play a large role in how much or how little we will suffer. Ashbey asserts, “While there are many things that influence outcomes, it’s not a formula.”

Humans are social animals, and while individual responsibility should never be dismissed, it is just as erroneous to assume that one accomplishes anything entirely alone.

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Eythana Miller is a transplant from Montana who has been delightedly living in Redding since 2018. She will transfer from Shasta Community College to UC Berkeley in the fall, studying political science and journalism to continue learning about and shining light on the issues facing both the local and global community. She said that being a Journalism Fellow has been an honor, and she’s excited to share more stories that are waiting to be told.

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