Four ACEs: 10 risk factors that could shorten your child's life


Every family in Vermont wants its children to grow up healthy, happy and protected from anything that might lead to illness and chronic disease. Adverse Childhood Experiences (ACEs) are preventable and children can prosper with the right support. As we learn more about ACES we understand that dealing a winning hand for kids doesn't have to be a game of chance.

We have long known that Adverse Childhood Experiences have negative mental health effects on children. We now begin to understand the profound effects that ACEs have on physical health, development of chronic disease (cancer, heart disease, obesity, asthma, liver disease, depression or others), brain development, reduced life expectancy, behavioral problems, poor performance in school, or the increased likelihood of incarceration and job failure.

The Center for Disease Control and Prevention recognizes ten types of abuse, neglect, and house-hold challenges that can lead to negative outcomes. ACEs include: physical, emotional, and sexual abuse; physical and emotional neglect; domestic violence; a family member with mental illness, a family member incarcerated, a family member with addiction, or an absent parent. Although poverty increases a child's risks, negative experiences affect children in every socioeconomic group. ACEs do not account for all risks leading to physical, social or other conditions. Nevertheless, the more ACEs a child experiences, the more significant the toll on his health.

In Vermont, over half the population has at least one ACE. About 12 percent of men and 17 percent of women have four or more ACEs. Four ACEs is a losing hand. A child who experiences four or more ACES has a significantly increased risk of heart disease in adulthood. Experiencing six or more ACEs reduces life expectancy by almost 20 years. One ACE is associated with 20 percent greater risk of heart disease. Four ACEs a 70 percent greater likelihood; six or more ACES, a 330 percent higher risk.

Without opportunities to build parenting skills, parents may be unaware of how ACEs might negatively affect their children's health. Because we tend to parent as our parents did, many problems can be perpetuated from generation to generation. Most pregnant women and their partners take childbirth classes. Yet virtually no one takes classes in parenting. We tend to repeat the parenting we experienced sometimes to the benefit of kids and sometimes not.

The good news is that many ACEs are preventable, and children who do suffer ACEs can build resilience and begin to reverse the effects with the right kind of support. A team of representatives from state agencies, the Governor's Office and the legislature collaborated over the past year to identify a framework to reduce ACEs in our state. The team began with results from a study on ACEs in Vermont that was directed by the Vermont Legislature in 2014. The team was supported and sponsored in its work by the Aspen Institute and the Robert Wood Johnson Foundation as part of a Health in All Policies Initiative.

We talked with communities across Vermont and learned that there is great potential for building on work that is already happening in our state. There is widespread commitment to helping families and their young children navigate challenges to reduce ACEs.

We identified a number of research based opportunities that can help turn things around. Vermont can expand its new baby home visiting program to include visits with a nurse for interested new parents. The concept of home visits is not new in Vermont. We have seen good results with this family-centered outreach. The addition of evidence-based outreach to target ACEs will ensure even more support for Vermont families and prevent childhood experiences from growing into lifelong health concerns.

It is critically important that Vermont parents know how they can prevent ACEs, and where to find support. We can focus on prevention by offering parenting classes as a universal part of prenatal care. Health care providers can conduct ACEs screenings when families come for primary care visits. Finally, we must make available prompt referral to services and support for parents and children who are affected by ACEs. This kind of integrated, holistic support will help shuffle the deck in favor of children and families.

As we continue to learn more about ACEs, we hope to see expanded prevention and support programs. Vermont can explore programs that offer screening and support for incarcerated individuals and their children, or school-based programs to identify, aid and refer children who suffer from ACEs. There is much more that we can and should do.

Knowing the incredible toll that ACEs have on the health and wellbeing of so many Vermont families — not to mention added costs to our health care system, our schools, and our corrections system — we cannot afford to leave this problem unaddressed. ACEs are preventable. It's time to deal Vermont kids and families a winning hand.

The members of the Vermont Aspen Team are Hal Cohen, Secretary of the Agency of Human Services, Tracy Dolan, Deputy Commissioner of the Department of Health, Bill Lippert, Representative, Robin Lunge, Health Director of the Governor's Office, Ginny Lyons, Senator, Ann Pugh, Representative, Ken Schatz, Commissioner of the Department for Children and Families, Beth Tanzman, The Vermont Blueprint for Health, and George Till, Representative. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.


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