Turning Gold into Lead

The Adverse Childhood Experiences Study

by Dr. Barbara Levin

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The importance of heredity on physical health has been appreciated for more than a century; for Jews of various ethnic groups, the genetic basis of certain diseases is quite important. Hypertension, heart disease, cholesterol problems, diabetes, and cancer all have components based on heredity and cultural backgrounds. Sometimes, what people eat and how they use their time impact their health as much as gene structure. The new science of epigenetics is shedding light on how environment affects gene expression.

There is increasing awareness of the importance of childhood experiences on both the mental and physical health of adults. Neurobiology research is shedding light on the connection between adverse early life experiences and adult behavior. The Adverse Childhood Experiences Study, by Dr. Vincent Felitti and the Center for Disease Control, documents the impact of ten types of negative events that children might encounter in three major categories: abuse, neglect or severe household dysfunction such as the loss of a parent.

The researchers surveyed 17,000 primary care patients at Kaiser Permanente in San Diego, California, and found that 60 percent had two or more of these adverse experiences, and 15 percent had four or more. Subsequent research has found that people who are overweight, smoke, drink alcohol to excess, have hypertension, and mental health disorders have higher scores than those without these past experiences. Patterns started in childhood, examples set, and the direct impact of extreme stress have a strong effect on the developing brain that persists throughout life.

Behavioral concerns must be addressed earlier by identifying children and youth at risk through improved screening and treatment. But the health care community alone cannot resolve these problems. The role of families and communities is essential.

Overcoming adverse early life experiences requires resilience. Being aware of one’s genetic background does not doom one to the disease, whether it is diabetes or breast cancer. Such information is the beginning of an action plan. So, too, with awareness of one’s ACE score. There are ways to increase one’s personal resilience.

Considering the magnitude of children’s behavioral health concerns, each of us must consider the impact of the ACE Study. There is much that we can do as mothers, wives, friends, community activists, teachers, professionals, and volunteers to affect change in a child’s life. We also can work as groups of committed women to improve the mental health of children in our communities.

Barbara Levin is a public health physician working for a quality improvement organization to assurethe quality of health care to Medicare recipients in their communities. She is a member of the Heska Amuna Synagogue sisterhood in Knoxville, Tennessee.