How is Oregon responding?
Oregon is starting to apply the lessons from the Adverse Childhood Experiences Study
Chart above: Research published in the the American Journal of Preventive Medicine (Vol 14, Issue 4 , May 1998) found “a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.”
The implications of the ACE Study are ... far reaching: adverse childhood experiences leave a trail of cognitive, behavioral, and health wreckages in their wake, and when untreated, these adverse experiences are often revisited on the next generation.
— Report to The Ford Family Foundation
When the findings of the groundbreaking Adverse Childhood Experiences (ACE) Study were released, they quickly raised national awareness of the lasting impact of early childhood trauma and the ways those consequences affect society at large.
The landmark study demonstrated strong links between traumatic childhood experiences and a host of adult health problems: cardiac disease, obesity, diabetes and depression. Further research has also found a strong link between these experiences and school failure and dropout, interpersonal violence, chronic unemployment and suicide.
"one of the most stunning pieces of data that we’ve seen"
The initial surveys were conducted between 1995 and 1997 by researchers from Kaiser Permanente and the Centers for Disease Control. The 17,421 participants were subsequently followed for more than 15 years.
The Ford Family Foundation, recognizing the gravity of these findings, commissioned a report to determine how the ACE Study is informing work with children and families in Oregon. The report, based on phone interviews and online research, is intended as an overview of activities and opinions.
The great transformation
Researcher David Mandell, who conducted the study, concludes that the impact of the study in Oregon has been strongest at the conceptual level, providing a framework for articulating, mapping and making sense of the work people are doing, rather than shaping specific practices or interventions.
It should come as no surprise that many of these efforts are still preliminary, Mandell writes, but in some ways, that is a good thing.
“Oregon is in the middle of transforming three of its largest service-delivery systems that impact children and families: health, education and early childhood. … As a result, this is a moment of unprecedented flux and uncertainty, as well as opportunity.”
Building bridges between health, education and early childhood is a continual theme of these transformation efforts, and nothing more tangibly demonstrates the need for those bridges than the study, which documents the lingering effects of childhood experiences in all of these systems.
A great opportunity
A number of interviewees noted that while the three transformations present a great opportunity to use the ACE framework to shift understanding, focus and practice, Oregon is not there yet.
As one interviewee put it, “Right now people are so busy in the weeds getting these things off the ground that they can’t step back and think about the big picture.”
The report also notes that many of the most concrete examples of ACES-inspired work in Oregon are taking place outside of the state-sponsored systems redesign.
They involve groups of local pediatricians thinking about how to address the needs of their patients more fully; early intervention programs, like Relief Nurseries, explaining to policy-makers how they are contributing to long-term health savings; mentoring programs helping their volunteers understand the impact of trauma on the adolescents with whom they are working; and local communities coming together to determine how they can collectively reduce rates of child abuse and neglect.
“The ACE Study is being explicitly and intentionally used in each of these examples,” the report says,
Janet Arenz, executive director of the Oregon Alliance of Children’s Programs, calls the ACE Study “one of the most stunning pieces of data that we’ve seen. We think this should be a policy foundation for how we make decisions about child well-being. I carry copies of this in my briefcase, and when I’m in a meeting I hand it out. Every legislator has received this more than once.”