By Robert F. Anda, Laura E. Porter, David W. Brown, et al., American Journal of Preventive Medicine, March 25, 2020 INTRODUCTION Despite its usefulness in research and surveillance studies, the Adverse Childhood Experience (ACE) score is a relatively crude measure of cumulative childhood stress exposure that can vary widely from person to person. Unlike recognized public health screening measures, such as blood pressure or lipid levels that use measurement reference standards and cut points...

Adversity in childhood can be prevented by going upstream and creating social policies that support optimal familial environments in early childhood. Such policies could focus on parenting, parent mental health and substance use, and poverty reduction, among other targets.

Exactly! Dr. McEwen, we so need to bring esteemed historian and patriot Heather Cox Richardson, PhD, into the conversation and exhortations on the science of positive and adverse childhood experiences. Were Dr. Richardson, author of the almost daily " Letters from an American " to frame our nation’s history through the lens of the traumas our peoples have endured, it would explain so much about our current collective trauma. Were she to link for her thousands of followers the science of how...

Dr. McEwen, This is not something new It is yet another study that indicates the focus of PACES research should be on the causative social and cultural factors.

As a clinician, researcher and policy specialist devoted to the prevention and treatment of the ill effects of child abuse and neglect (CAN) I read “Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine” (Sherin KM, Stillerman A, Chandrasekar L, Went N, Niebuhr DW. Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the...