As I described in my previous two posts, the Adverse Childhood Experiences (ACE) Study discovered that traumatic events – divorce, neglect, domestic violence – are associated with many of the leading causes of death in the United States. While some were skeptical of the initial results, the ACE Study is now in its 13th year, and over 50 publications support the findings. The study is currently in its prospective phase, meaning that the original group of adult participants, whose childhood experiences were examined retrospectively, are now being followed into the future to see how their reports of childhood trauma and adversity are associated with ongoing changes in their health.
So why might traumatic experiences early in life put people at higher health risk? Scientists are not really sure. There are plenty of theories, and most believe that it has something to do with our bodies’ natural stress response systems such as fight-or-flight. As explained by Dr. Sandra Bloom, psychiatrist, expert on trauma, and associate professor at the Drexel University School of Public Health, these systems evolved over millions of years to protect pre-historic humans from threats in the natural world (more on that in a future post). Some also think that it has a lot to do with emotions and feelings of self worth.
Like the original researchers, I was astounded when I first learned of the ACE Study findings. Why, then, have so few people, outside a relatively small circle of academics, heard about it?
For one, I think it conflicts with mainstream cultural ideals. “Suck it up,” “put the past behind you,” “forget about it and move on” — these are the slogans of a society that places great emphasis on free will. We like to think that our future should not be bound by our past, and that our health is determined solely by our own rational choices. As much as we might want to believe this, the ACE Study suggests that our biology and psychology say otherwise.
Secondly, the ACE Study tells us that a lot of horrible things happen to a lot of kids. The occasional story on the evening news is one thing, but the ACE Study revealed that one in four women were sexually abused as girls. I don’t think we want to believe that these horrific events are as common as they are. Health studies typically uncover things like high-risk genes; the ACE Study uncovered family secrets.
Finally, it raises the question of what we do with this information. Popular models of health behavior change are not necessarily well-suited to address complex childhood trauma (promising practices do exist, however, and will be discussed in a future post).
The ACE Study asks us to recognize that improving the health of the public requires confronting what goes on behind closed doors, in the most private of places.
This is the last of three posts in a mini-series that begins the exploration of a topic - trauma and health – that I will return to periodically. Upcoming posts will examine issues like urban violence, the “science of trauma,” and what people in Philadelphia are doing to address these issues.
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