(San Diego) Over 100 mental health providers, educators and consumers gathered at the Jacobs Center for Community Development on Saturday, September 12, to be introduced to Adverse Childhood Experiences (ACE) and the impact it is having on adult health. The forum was designed to share information about ACE-related issues and to determine how these findings and impact health and social outcomes in San Diego.
“We are absolutely thrilled that we were able to design and implement this type of community information session about an issue as important as Adverse Childhood Experiences,” explained Clovis Honore, president of San Diego Black Health Associates (SDBHA). “Our next steps include broadening our planning base to include young consumers and action-oriented adults, as well as other health professionals who want to address this problem.”
Vincent Felitti, MD, Founder and Chairman (retired) of the Department of Preventive Medicine at Kaiser Permanente Health Plan was the initial speaker. Dr. Felitti is the Principal Investigator in ACES research, in collaboration with the Centers for Disease Control and Prevention. Along with Dr. Felitti was Dr. Cheryl Grills, psychologist, chairwoman of the Department of Community Psychology at Loyola Marymount College and Co-Executive Director of the LA County Blue Ribbon Commission on Child Protection. Dr. Grills also serves on the Sybil Brand Commission for Institutional Inspections appointed by the LA County Board of Supervisors (2010).
The forum was designed and implemented by San Diego Black Health Associates, a non-profit public health advocacy organization committed to helping improve the health status of African Americans in San Diego County. Founded in 1978, SDBHA has provided community health improvement programs in churches, schools, community-based organizations and barbershops. Co-sponsoring the forum was Harmonious Solutions, a minority mental health provider that has worked with the African American community over the past five years.
Mack Jenkins, Chief Probation Officer with the County, speaking about the forum, said, “I found the presentations had a very powerful and informative message on the issue of Adverse Childhood Experiences. In my career, we have not had much orientation on ACE-related issues. I am generally more familiar with generational-style abuse of the operations of the juvenile justice system.”
Mr. Jenkins believes the next forum should address systemic responses to ACEs, both for broader San Diego community and for African Americans.
Adverse Childhood Experiences occur when circumstances result in physical, mental, emotional, sexual abuse and household dysfunctionalities. Dr. Felitti’s research has determined that people with six or more adverse childhood experiences died nearly 20 years earlier than those with no ACE’s. The issue of abuse emerged originally through patient response to participating in a fasting program managed by Kaiser. Through a series of interviews and subsequent independent assessments, it was determined that a large middle class people was struggling with abuse, hostilities and neglect, without a comprehensive response from the medical community.
Dr. Grills began her presentation by citing the special thoughts and quotes from historians and icons in the struggle for freedom. Harriet Tubman was known to say “I freed 1000 slaves and would have freed 1000 more, if I could have convinced them that they were slaves.” Grills also cited Langston Hughes questioned “How something is seen, depends on whose eyes are looking at it. Toussaint questioned “If you are silent about your pain, they will kill you and say that you enjoyed it.”
Dr. Grills then evaluated the ACES data from an Afro-Centric perspective – and with a comparison onto the backdrop of conditions in this society. “These backdrops could be the war on drugs in the 1970’s and now the school-correctional pipeline, in the 1990’s and 2000. “As African Americans, we recognize the multiple stacking of adverse consequences over multiple years. Some African Americans left the south knowing if they did not leave, they would be killed. This forced migration within the country could be likened to migrant shifts throughout the world today. You cannot begin to understand the problems that are amplified over multiple lifetimes. Multi-generational adversities result in diminished hopes and suppressed visions. “As African Americans, we have been excluded, rejected, marginalized and been abused. We still find ourselves on the lowest rung of the bottle in every dimension,” Noted Dr. Grills. “But we are still here.”
Dr. Grills believes that the fibers and the forces which have called African American people together must continue to work to ensure positive outcomes. “We must learn how to survive against the odds. We need to study that, as much as we need to fully understand societal dysfunction. Our younger generation is dealing with the prison pipeline and abandoned job opportunities.
Rev. Wendell M. Bass, Jr., a long-time educational advocate in San Diego and once Principal at Lincoln High School, urged collaboration and strategic action between mental health, physical health and education resources locally.
“It is imperative that the ACE information be linked to the Pre-K to 12th grade system in a very real and useful way. All administrators, teachers and staff need to know how adverse childhood experiences can impact learning and the social, emotional, psychological health of children and their families. Academic achievement can accelerate when we help our children and families handle the adverse things that they go through. Healthy children become healthy adults.”
Dr. Jeffrey Brenner is the Founder of the Camden Coalition of Healthcare Providers and Medical Director of the Urban Institute at Cooper University Healthcare. Last year (January 29, 2014), Dr. Brenner wrote a “blog” which described Adverse Childhood Experiences data and outcome as follows:
“For nearly 15 years, we’ve had the secret to delivering better care at lower cost in America. The information has sat hidden away in the medical literature, and barely mentioned among physicians. It’s a remarkable story of bias. The neglect of this information by the medical community tells you a lot about our failings as a profession and the poor training we receive. It is also a powerful commentary on the values of our society and the biases built into our society’s view of health and healthcare.”
The ACE score predicted healthcare utilization, healthcare spending, obesity, substance abuse, smoking, alcoholism, and prevalence of poorly controlled chronic diseases better than anything the health care industry has ever found.
“The terrible things that sometimes happen to children can cause a lifetime of health impacts”, Brenner said. “This is true for middle class patients. Poverty magnifies the potential to have higher ACE score and possibly exacerbates any trauma that have occurred”.
The forum was sponsored by The California Endowment, UC San Diego Health, First 5 San Diego, The California Wellness Foundation, Alliance Health Clinic, The San Diego Voice and Viewpoint and Kaiser Permanente.
As Dr. Harold Freeman, Past President of the American Cancer Society said, when commenting on access to health care in the United States (2014), noted the principal reason for this health disparity is the disconnect between the nation’s discovery and delivery enterprises — between what we know and what we do about sick Americans.
For further information about Adverse Childhood Experiences, contact SDBHA at [email protected] or via telephone at (619) 906-4002.
