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PACEs in Medical Schools

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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]

By Bob Erlenbusch and Drew Factor, California Health Report, November 20, 2019 “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying. According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common,...
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Philadelphia doctor takes to streets to help black communities get tested for COVID-19 (ABCNews)

Karen Clemmer ·
By Jon Schlosberg, Lindsey Davis, and Sabina Ghebremedhin, April 29, 2020, ABC News Dr. Ala Stanford isn't a pastor, though she's often at church and many in Philadelphia will tell you she is doing God’s work. ‘Hallelujah that God made a way,” said Gwen Carter as she waited to be tested for COVID-19 at Mt. Airy Church of God in Christ in Philadelphia on Friday. Stanford has tested more than 1,500 deeply appreciative residents in some of the city’s poorest neighborhoods. She does not charge a...
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Preventable trauma in childhood costs north America and Europe US$ 1.3 trillion a year [WHO]

Karen Clemmer ·
By World Health Organization (photo by WHO/Malin Bring) The findings of a new study on the life-course health consequences and associated annual costs of adverse childhood experiences (ACEs) show that preventable trauma in childhood costs north America and the European Region US$ 1.3 trillion a year. The article, published in the Lancet and co-authored by Dinesh Sethi and Jonathon Passmore, Programme Manager, Violence and Injury Prevention, WHO/Europe, looks at the legacy of ACEs and their...
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Screening for ACEs in Pediatric Practice [American Academy of Pediatrics - CA Chapter 2]

By Ariane Marie-Mitchell, American Academy of Pediatrics, October 2019 In the August newsletter, we provided an overview of the definition and impact of adverse childhood experiences (ACEs) (http://aapca2.org/aces). In this article, we will explore the argument in favor of screening for ACEs in pediatric practice, and describe the process and results of a California state advisory group on screening for trauma. The American Academy of Pediatrics (AAP) recommended screening for toxic stress...
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Sheltering in Place: ACEs-Informed Tips for Self-Care During a Pandemic

Jim Hickman ·
Millions of lives have been affected in unprecedented ways by the Coronavirus (COVID-19). We are all grappling with uncertainty—our daily routines interrupted, not knowing what is to come. For those of us who have Adverse Childhood Experiences (ACEs), these times can be particularly distressing. At the Center for Youth Wellness (CYW), we know that childhood trauma can have a significant impact on an individual’s health and well-being – both physiologically and psychologically. Since the...
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The Black Community, COVID-19 & Trauma [sdvoice.com]

By Latanya West, San Diego Voice, May 15, 2020 In January 2019, Governor Gavin Newsom appointed Dr. Nadine Burke Harris as California’s first-ever Surgeon General. An award-winning physician, researcher and advocate, Dr. Burke Harris’ career has been dedicated to serving vulnerable communities and combating the root causes of health disparities. Her work is equally dedicated to changing the way our society responds to one of the most serious, expensive and widespread public health crises of...
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The Impact of Childhood Adversity on Health and COVID-19 [acpm.org]

By Kevin Sherin, American College of Preventive Medicine, May 7, 2020 There is a growing dialog about COVID-19 and its impacts on childhood adversity (ACEs), chronic stress, and mental health across the lifespan. The fear and social isolation associated with COVID-19 commonly exacerbates existing chronic stresses. Reports are surfacing of increased mental health problems, anxiety, partner violence, depression, suicidality, child abuse, opioid use disorder, other substance abuse, drug...
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TIC: News and Notes for the Week of October 21, 2019 [dhs.wisconsin.gov]

Scott A Webb ·
ACEs, Adversity's Impact There is only one boat: The myth of normalcy by Dr. Gabor Mate Understanding historical trauma to strengthen community Childhood trauma linked to early, premarital childbirth and poor health for women Early life racial discrimination linked to depression, accelerated aging When mothers are killed by their partners, children often become 'forgotten' victims. It's time they were given a voice Children's language skills may be harmed by social hardship Does racism...
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Tools and how to use them is focus of second webinar on Community Resiliency Model, May 14, 2020

Carey Sipp ·
The second of two free Community Resiliency (CRM) webinars with Elaine Miller-Karas , key creator of the CRM, will be held Thursday, May 14, from 11 a.m. - 12:30 p.m. ET, (10 a.m. CT; 9 a.m. MT, and 8 a.m. PT) and will include the practical application of tools of the model. CRM is an ACEs science-based biological model for helping individuals become emotionally regulated during natural disasters and other dysregulating times. Miller-Karas will be joined by CRM trainers from Wilmington, NC:...
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Trauma-Informed Care as a Universal Precaution: Beyond the Adverse Childhood Experiences Questionnaire [jamanetwork.com]

By Nicole Racine, Teresa Killam, and Sheri Madigan, JAMA Pediatrics, November 4, 2019 Experiences of childhood adversity are common, with more than 50% of adults reporting having experienced at least 1 adversity as children and more than 6% exposed to 4 or more adverse childhood experiences (ACEs). There is currently a controversial debate in the medical field as to whether the ACEs questionnaire, which asks about abuse, neglect, and household dysfunction before age 18 years, should be...
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Webinar Oct. 17 — Integrating ACEs science in pediatrics: Early adopters share lessons from the field

Laurie Udesky ·
An ACEs Connection webinar co-sponsored with 4 CA In 2017, California became the first state in the country to pass a law supporting universal screening for adverse childhood experiences (ACEs) in the 5.3 million children in the state’s Medicaid program. As clinicians around California await the state’s announcement of what this new policy will entail, many are wondering what it takes to integrate ACEs science in a pediatric practice. Meet Drs. Deirdre Bernard-Pearl, R.J. Gillespie and...
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Why Is the Pandemic Killing So Many Black Americans [podcasts.apple.com]

Carey Sipp ·
By The Daily, The New York Times, May 20, 2020 Some have called the pandemic “the great equalizer.” But the coronavirus is killing black Americans at staggeringly higher rates than white Americans. Today, we explore why. Guest: Linda Villarosa, a writer for The New York Times Magazine covering racial health disparities, who spoke to Nicole Charles in New Orleans, La. about the death of her husband, Cornell Charles, known as Dickey. He was 51. For more information on today’s episode, visit...
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Young adults with PTSD may have a higher risk of stroke in middle age (UNC Healthcare)

Karen Clemmer ·
Lindsey Rosman, Ph.D., assistant professor in the division of cardiology, is the lead author of the study, the story was published on Oct 17, 2019, for UNC Healthcare and UNC School of Medicine. CHAPEL HILL, N.C. — Oct. 17, 2019 — Young adults who suffer from posttraumatic stress disorder (PTSD) may be more likely to experience a transient ischemic attack (TIA) or major stroke event by middle age, raising the risk as much as other better-known risk factors , according to new research...
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ACEs & African Americans Community on ACEs Connection

ACEs Connection envisions a resilient world where ALL people thrive. We are an anti-racist organization committed to the pursuit of social justice. In our work to promote resilience and prevent and mitigate ACEs, we intentionally embrace and uplift people who have historically not had a seat at the table. ACEs Connection celebrates the voices and tells the stories of people who have been barred from decision-making and who have shouldered the burden of systemic and economic oppression as the...
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Announcing Trauma and Resilience Competencies for Nursing Education

Kathleen Wheeler ·
The authors are pleased to announce the Trauma and Resilience Competencies for Nursing Education. These competencies serve as a guideline of minimal expectations and reflect essential knowledge, skills and behaviors for three levels of nursing education: 1) undergraduate, 2) graduate, and 3) psychiatric nurse practitioner programs. The Trauma and Resilience Competencies, developed in 2018 at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut by an Expert...
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Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic [jamanetwork.com]

By Abby R. Rosenberg, JAMA Pediatrics, April 14, 2020 Coronavirus disease 2019 (COVID-19) is affecting our health care community in unprecedented ways. As a pediatric oncologist who studies resilience in the context of illness, I started thinking about what this pandemic means for our professional resilience a few weeks ago, when the first US patient with fatal COVID-19 died in my home city of Seattle, Washington. Promoting resilience among health care workers and organizations starts with...
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Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations [science.sciencemag.org]

By Ziad Obermeyer, Brian Powers, Christine Vogeli, and Sendhil Mullainathan, Science, October 25, 2019 Racial bias in health algorithms The U.S. health care system uses commercial algorithms to guide health decisions. Obermeyer et al. find evidence of racial bias in one widely used algorithm, such that Black patients assigned the same level of risk by the algorithm are sicker than White patients (see the Perspective by Benjamin). The authors estimated that this racial bias reduces the number...
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Dr. Nadine Burke Harris (podcast) [armchairexpertpod.com]

By Dax Shepard, Armchair Expert, October 10, 2019 Nadine Burke Harris is an American pediatrician who is the 1st and current Surgeon General of California. She is known for her work in adverse childhood experiences. Nadine visits the Armchair Expert to discuss the impact childhood trauma has on health and longevity, she talks about her own experience with childhood adversity and she gives tools to buffer those who have many ACEs. Nadine talks about the screening process she pioneered and Dax...
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Dr. Vincent J. Felitti, M.D. has been recognized with the Albert Einstein Award of Medicine by the International Association of Who’s Who [kentuckyreports.com]

By Kentucky Reports, November 9, 2019 Dr. Vincent J. Felitti has over 50 years of experience in the field of Internal Medicine with extensive knowledge in the areas of childhood trauma, the genetic disease Hemochromatosis, and obesity. Serving as a Clinical Professor of Medicine at the University of California since 1982, Dr. Felitti’s knowledge and experience is broad and significantly biopsychosocial. Dr. Felitti achieved his Medical Degree from Johns Hopkins in 1962 after being inspired...
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Efforts to Reduce Black Maternal Mortality Complicated by COVID-19 [chcf.org]

By Xenia Shih Bion, California Health Care Foundation, April 20, 2020 Latoyha Young had a birth plan. She was going to have the baby in Sacramento with community doula Joy Dean by her side. Dean was funded by the county’s Black Child Legacy Campaign , which works to reduce the disproportional number of Black infant and child deaths in Sacramento. But in mid-March, when Young went into labor just as Governor Gavin Newsom ordered Californians to stay at home to avoid spreading the novel...
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Fed Up With Deaths, Native Americans Want to Run Their Own Health Care [nytimes.com]

By Mark Walker, The New York Times, October 15, 2019 When 6-month-old James Ladeaux got his second upper respiratory infection in a month, the doctor at the Sioux San Indian Health Service Hospital reassured his mother, Robyn Black Lance, that it was only a cold. But 12 hours later James was struggling to breathe. Ms. Black Lance rushed her son back to the hospital in western South Dakota, where the doctors said they did not have the capacity to treat him and transferred him to a private...
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Healing Hurt People: Helping Victims of Violence Heal from Their Trauma and Become Community Peer Health Workers [citywidestories.com]

By Michael Butler, City Wide Stories, November 1, 2019 Healing Hurt People started in 2008 as an initiative to help victims of violence heal and deal with the trauma of their injuries; more than a decade later the organization has created a sustainable model for hospitals across the city of Philadelphia. Young men that have dealt with violence are encouraged to go through training, become community peer health workers, and help those who have gone through similar experiences. We spoke with...
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Healthy Spaces December 2019 Webinars

Aldina Hovde ·
Healthy Spaces: Promoting Healthy and Resilient Communities December 2019 Webinars Funding provided by the New Jersey Department of Children and Families The New Jersey Chapter, American Academy of Pediatrics (NJAAP) believes that all children deserve to feel safe and secure in their home, at school, and while at play. The Healthy Spaces program aims to address adverse childhood experiences (ACEs) through partnerships with pediatric/family healthcare teams, schools and communities.
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Intimate Partner Violence Screening and Intervention: The American College of Preventive Medicine Position Statement (Abstract) [sciencedirect.com]

By Tanya M. Phares, Kevin Sherin, Suzanne Leonard Harrison, et al., American Journal of Preventive Medicine, December 2019 The purpose of this paper is to produce a position statement on intimate partner violence (IPV), a major sociomedical problem with recently updated evidence, systematic reviews, and U.S. Preventive Services Task Force guidelines. This position statement is a nonsystematic, rapid literature review on IPV incidence and prevalence, health consequences, diagnosis and...
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Jones: Day 2: Soda, cigarettes and trauma: How Adverse Childhood Experiences alter brain chemistry, cultivate unhealthy habits and prompt premature death

Linda Manaugh ·
Patients would carry soda into Dr. Gerard Clancy’s office, with cigarettes tucked away for after therapy. Often victims of abuse or violent crime, they would seek soothing but risky behaviors to cope. Overweight. Chronic pain. Chronic obstructive pulmonary disease. Type II diabetes. His former patients will die younger than they should, he said. Clancy conducted therapy sessions until he became president of the University of Tulsa in 2016. At his psychiatry clinic, he saw firsthand how a...
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Information and Updates on COVID-19 [acpm.org]

From American College of Preventive Medicine, May 2020 Preventive Medicine Physicians are our nation's first line of defense against pandemic disease. They are responding to the current COVID-19 pandemic with dedication, expertise and unfailing commitment to public health. We are curating a collection of well-vetted resources on COVID-19 for physicians, families and anyone interested in learning more about the coronavirus. Read our new blog, Preventive Medicine Responds to COVID-19 HERE. [...
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What Do Coronavirus Racial Disparities Look Like State by State [npr.org]

Carey Sipp ·
By Maria Godoy and Daniel Wood, National Public Radio, May 30, 2020 In April, New Orleans health officials realized their drive-through testing strategy for the coronavirus wasn't working. The reason? Census tract data revealed hot spots for the virus were located in predominantly low-income African-American neighborhoods where many residents lacked cars. In response, officials have changed their strategy, sending mobile testing vans to some of those areas, says Thomas LaVeist , dean of...
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Commentary: Why so many black Americans are dying from COVID-19 and how to make health care equitable (sandiegouniontribune.com)

Evidence suggests that during the early phase of the coronavirus pandemic, blacks are suffering the greatest death rates compared to all other ethnic groups. Why? I can assure you that the coronavirus does not discriminate based upon skin color or ethnicity. Instead, it has a predilection for populations with the highest rates of chronic diseases, poor access to health care and too little information from trusted sources. For decades, the National Medical Association — which represents more...
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What Do We Do? What Do We Do Now?

Jane Stevens ·
People’s response to the great chasms of structural inequities glaringly laid bare by the COVID-19 pandemic have been further inflamed by the murder of George Floyd and deaths of other African Americans in recent weeks. The acute emergency of the pandemic has eased, but the violence inflicted on racial minorities and now those who are protesting the inequities in our society has compounded the outrage. Right after the pandemic began running riot across the US, I often heard people ask: When...
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Could Community Health Workers and Promotores de Salud Help California Respond to COVID-19? (CHCF Blog)

Karen Clemmer ·
By Rob Waters, June 4, 2020, California Health Care Foundation. Aida Meza has been working as a promotora de salud, a community health worker, since she moved across the border from Tijuana, Mexico, to the San Diego area 23 years ago. She came to Chula Vista with her husband, an American citizen, so they could send their kids to better schools. “At first I cried every day because I wanted to go back to my home,” she said. Then the principal at her children’s school, Vista Square Elementary,...
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North American Libraries Send Strong Message of Inclusion, Commitment to Racial and Social Equity, to Their Communities (Urban Library Council)

Karen Clemmer ·
June 1, 2020, Urban Libraries Council Newsroom Blog. In a strong act of commitment to a more equitable society, 164 public libraries across North America signed the Urban Libraries Council’s Statement on Race and Social Equity . This statement serves as a baseline upon which libraries can build policies and actions that make their communities more inclusive and just. [ Please click here to read more. ]
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Advancing Racial Equity Webinar Series [apha.org]

By Tia Taylor Williams, American Public Health Association, May 2020 Alarming disparities within the COVID-19 pandemic — such as higher hospitalizations and death rates among African Americans — are sadly predictable and highlight the urgent need to address the root causes of health inequities. APHA is hosting this four-part webinar series to give an in-depth look at racism as a driving force of the social determinants of health and equity. The series will explore efforts to address systems,...
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Diagnosing and Treating Systemic Racism (NEJM)

Karen Clemmer ·
June 10, 2020. Michele K. Evans, M.D., Lisa Rosenbaum, M.D., Debra Malina, Ph.D., Stephen Morrissey, h.D., and Eric J. Rubin, M.D., Ph.D. For the New England Journal of Medicine. For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with Covid-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need has rarely been clearer. But as George Floyd’s repeated...
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Doctor Goes Viral for Explaining How Biases Affect the Healthcare Black Patients Receive (Distractify)

Karen Clemmer ·
By Robin Zlotnick, June 9, 2020, Distractify. If you want concrete evidence of deeply ingrained racism, look no further than our doctors and healthcare workers. Dr. Jennifer Lincoln is going viral on TikTok for explaining just how rampant implicit bias is in hospitals and doctors' offices. She highlights a 2016 study , which found that about half of white medical students and residents subscribed to the false narrative that Black people feel less pain than white people and were more likely...
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2020 Health Equity Call for Research (AAMC)

Karen Clemmer ·
2020 Health Equity Call for Research: AAMC Consumer Survey of Health Care Access Introduction In recognition of the importance of research and the dissemination of evidence-based solutions to achieve health equity, the AAMC (Association of American Medical Colleges) founded the Collaborative for Health Equity: Act, Research, Generate Evidence (CHARGE), a forum for investigators, clinicians, and community partners to collaborate and improve upon research that aims to minimize disparities in...
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Racism's Effect on Health, and the Heartbreak of Being a Black Parent Right Now: California's Surgeon General Speaks [kqed.org]

By KQED Science, KQED, June 14, 2020 The coronavirus pandemic and the recent killing of George Floyd have brought longstanding racial inequities into sharp focus. One of those disparities concerns the high rate of coronavirus transmission among people of color. To talk about the intersection of race and health, KQED's Brian Watt spoke last week with California Surgeon General Dr. Nadine Burke Harris, who is known for her pioneering work on the role that childhood stress and trauma play on...
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Inside Boston Hospitals, A Reckoning With Racism (WBUR)

Karen Clemmer ·
By Martha Bebinger, June 19, 2020, WBUR As calls for racial justice continue on Boston streets, conversations have shifted to what’s next. That’s true inside hospitals as well, where the life-long effects of racism play out every day. “You could almost take any chronic disease in America, diabetes, hyper-tension, and there will be higher rates and worse outcomes in Black Americans,” says Dr. Rose Olson, a resident physician at Brigham and Women’s Hospital. “That’s not due to biology or...
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Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms (NEJM)

Karen Clemmer ·
By Darshali A. Vyas, M.D., Leo G. Eisenstein, M.D., and David S. Jones, M.D., Ph.D., June 17, 2020, NEJM. Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful. 1 Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of...
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Humana: ‘Unhealthy Days’ For Medicare Population Fall As Social Determinants Screened (Forbes)

Karen Clemmer ·
By Bruce Japsen, June 18, 2020, Forbes. A project by Humana to improve the health of seniors in private Medicare plans through better management of patient populations continues to show improvement five years into the effort, the health insurer said in a new report. Humana’s “Bold Goal” initiative, which began in 2015, uses measures established by the Centers for Disease Control and Prevention to track an individual’s physical and mental “unhealthy days” over a 30-day period. The social...
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ACEs screening is about building relationships, says early adopter

R.J. Gillespie ·
Whether or not to screen for ACEs in primary care is an important debate—and I hear and respect the passion from both sides of the argument. I fall in the “pro-ACE assessments” camp, but with some important caveats. I think that assessments for ACEs are dramatically different from screening for autism or developmental delays. In my opinion, assessments for ACEs in primary care should be primarily about building relationships.
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Linda Grabbe: Helping her communities develop resilience through the Community Resilience Model

Sylvia Paull ·
Grabbe searched for models that would help her homeless and addicted patients. “There are good body-based models for psychotherapy, which may be the most effective approach for trauma,” she says, “but hardly any of my patients were receiving any kind of therapy. There are thousands of people in our communities who have high ACE scores who will never get the years of psychotherapy they deserve. CRM is a self-mental wellness care tool and is exquisitely trauma-sensitive—so it can help enormously.”
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A Better Normal Tuesday, June 30th at Noon PDT: Reinterpreting American Identity, a Community Discussion

Alison Cebulla ·
"I think that all of us, regardless of our racial or ethnic background, feel relieved that we no longer have to deal with the racism and the sexism associated with the system of slavery. But we treat the history of enslavement like we treat the genocidal colonization of indigenous people in North America, as if it was not that important, or worse, as if it never happened." —Angela Davis, "The Meaning of Freedom" Please join us for the ongoing community discussion of A Better Normal, our...
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Stolen Breaths [njem.org]

By Rachel R. Hardeman, Eduardo M. Medina, and Rhea W. Boyd, New England Journal of Medicine, June 10, 2020 In Minnesota, where black Americans account for 6% of the population but 14% of Covid-19 cases and 33% of Covid-19 deaths, George Floyd died at the hands of police. “Please — I can’t breathe.” He was a black man detained on suspicion of forgery, an alleged offense that was never litigated or even charged, but for which he received an extrajudicial death sentence. “Please — I can’t...
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Academic Medicine and Black Lives Matter Time for Deep Listening (NEJM)

Karen Clemmer ·
By Clyde W. Yancy, MD, MSc 1 , JAMA. Published June 30, 2020. doi:10.1001/jama.2020.12532 E choes of “medicine as the noble profession” continue to resonate, now 35 years since my legendary Chair of Medicine imbued me with this guiding ethos. Nobility in medicine is not obsolete; the selflessness, courage, self-sacrifice, and altruism on gallant display in the response to COVID-19 reassures that at its core, this ethic of egalitarian service remains intact and deeply established in the DNA...
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Resilience for Children & Families: Being Brave When Things are Hard

Building Resilience with Children During Racial Discrimination & Violence: This attached Resilience Brief for Children has been the hardest one I have written yet. I have been an active advocate for the equal treatment of people from all backgrounds, religions, ethnic heritages, orientations, and families my entire life. It is hard to see the pain present today, not only due to COVID19 but also due to the harm and anger we see daily in the news. I want to share a story about the person...
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Academic Medicine and Black Lives Matter Time for Deep Listening (NEJM)

Karen Clemmer ·
By Clyde W. Yancy, MD, MSc 1 , JAMA. Published June 30, 2020. doi:10.1001/jama.2020.12532 E choes of “medicine as the noble profession” continue to resonate, now 35 years since my legendary Chair of Medicine imbued me with this guiding ethos. Nobility in medicine is not obsolete; the selflessness, courage, self-sacrifice, and altruism on gallant display in the response to COVID-19 reassures that at its core, this ethic of egalitarian service remains intact and deeply established in the DNA...
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Resilient Georgia and Georgia Public Broadcasting present "Mental Fitness for Resilience" Second Panel - The Trauma of Racism

Carey Sipp ·
Resilient Georgia recently presented a roundtable discussion, featuring a distinguished panel of professionals, on the trauma associated with racism and racial discrimination, as part of the Mental Fitness for Resilience Campaign. The distinguished panel for this Georgia Public Broadcasting production included Dr. Patrice Harris, MD, MA, psychiatrist and the first African-American woman to be elected president of the American Medical Association; Dr. Terri McFadden, a General Pediatrician...
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Reimagining Healthcare as a Community Investment

Jennifer A Walsh ·
At this point, COVID-19 has been a part of our lives for nearly six months now. While the most recent current events are not unfamiliar social problems, this pandemic has provided us with a stronger lens with which to see many of the underlying inequities within our communities. This article, “The Moral Determinants of Health,” explores these inequities by illustrating the systemic imbalances within the field of medicine and the amount of resources we allocate to solving problems as opposed...
Comment

Re: Reimagining Healthcare as a Community Investment

Jeoffry Gordon ·
Let us be clear: Guaranteeing medical services as a right to all Americans is not only a moral mandate, it is an investment in individual freedom and capacity, in family security and opportunity, as well as community solidarity and peace. The rest of the mature developed world places this priority along side fire departments, schools, and housing as collective public goods guaranteed by the government. Here in the USA this moral mandate has been retarded first by racism (those states which...
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Do safe, stable, and nurturing relationships work? New research has important findings for responding to ACEs

Alyssa Koziarski ·
While we know that adverse childhood experiences (ACEs) can cause risk behaviors, research has told us that the presence of protective factors can help mitigate the effects of ACEs. Common risk behaviors such as smoking tobacco and alcohol misuse can be a result from the trauma of childhood disadvantage. In responding to ACEs, public health research proposes that protective factors such as safe, stable, nurturing relationships (SSNRs) with a caring adult can mitigate the long-term effects of...
 
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