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The Health Foundation of Central Massachusetts

September 22, 2017 - Telegram & Gazette - Worcester HEARS
Attacking health problems through science

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Attacking health problems through science

By Clive McFarlane, Columnist

September 22, 2017

Deniers of climate change and other science sometimes come across as buffoons to many of us, but like volcanic eruptions, they are often merely representing the deep-seated rupture between beliefs and facts that undergird our lives.

Indeed, no matter how convincing the science, it generally takes a concerted and often courageous social promotion to bring about widespread acceptance of its import, if the science is ever accepted at all.

In the mid 1990′s, for example, the Centers for Disease Control and Prevention in a collaborative study with Kaiser Permanente conducted confidential surveys of more than 17,000 Southern Californians receiving physical exams.

The findings were startling.

Participants who as children were subjected to abuse and trauma, or what the CDC termed “Adverse Childhood Experiences(ACES),” significantly raise their risk for seven out of 10 of the leading causes of death in the U.S, including ischemic heart disease, cancer, chronic lung disease, skeletal fractures and liver disease.

According to the CDC, ACES include physical, emotional and sexual abuse, physical and emotional neglect, and household dysfunction such as divorce, incarceration, mental illness and substance abuse.

And according to the organization’s findings, the higher the variety and the longer the duration of ACES, the greater the likelihood of a child developing debilitating health issues later in life.

Yet, some 20 years later doctors are still not trained in routine screening and treatment of ACES, according to Dr. Nadine Burke Harris, a pediatrician who is leading the charge to create a national movement to address early childhood adversities and their impact on an individual’s long-term health.

“ACES affect brain development, the immune system, the hormonal system, even the way our DNA is read and transcribed,” Dr. Carter, CEO of the Center for Youth Wellness, said in an interview Tuesday at Worcester Technical High School, where she later spoke about her work to a receptive audience of healthcare professionals, educators and others.

Folks who are exposed to high doses have tripled risk to heart disease and lung cancer, and a 20-year difference in life expectancy.

Part of the slow response to ACES by the medical profession is procedural, she said, noting that it generally takes about 17 years between research findings and their integration into physician practice.

In addition, while the researchers saw the “powerful association” between ACES and a person’s long-term health, they didn’t know why, she said.

In the intervening years, however, advances in molecular biology, and neurobiology, and DNA mapping have allowed us to know “more than ever before how early adversity changes the brain of children. It also means we have more tools than we had before to interrupt that progression.”

The question is whether this knowledge and the available tools will finally lead to ACES being routinely screened for and treated.

Much, for example, has been written over the decades on how racism and the corrosive social conditions it generates contribute to poor health and premature death among African Americans, but racism is still not seen as the health crisis it is.

Dr. Harris noted that responses to some crises are often muted, if people think it is not their problem but that “it only impacts another ZIP code.”

ACES, she said, is different. Seventy percent of the participants in the Kaiser/CDC study were Caucasian and 70 percent were college educated, she noted. In addition, she said that almost two-thirds of the population have experienced at least one ACES, which will allow more people to find common ground on the issue.

From an economic standpoint, she also noted that the country spends almost $3 trillion a year on healthcare, 75 percent of which is spent on treating chronic illnesses.

“At some point, it doesn’t matter if you are on the red or blue side of the aisle,” she said. “The science is clear.”

Dr. Carter, who first began studying the issues when an “epidemic level” of students were being referred to her for ADHD consultation, said evidence suggests that sleep, exercise, nutrition, mindfulness, mental health and healthy relationships help reduce the negative impacts of ACES.

“All of these things enhance brain development, reduce inflammation and reduce stress hormones and protects our DNA from premature cellular aging.”

She said she is encouraged by the work Worcester educators, health professionals, and others, such as the Health Foundation of Central Massachusetts, the Greater Worcester Community Foundation and UMass Memorial Health Care are doing to address childhood trauma.

“We are not suggesting getting rid of all childhood adversity. That would be undesirable. But we can move profoundly in a healthier direction by recognizing what the real cause of many of our chronic illnesses and taking incremental measures to address them.

“Similarly, when we understand the fundamental problem, then what we can do is to start on the most individual level to create change, to say ‘let’s see what I can do to heal myself and prevent the spread.’”

The diagnosis and the treatment seem straightforward. Unfortunately, we live in a world in which scientific evidence is merely another opinion to many.