Wednesday, April 23, 2014

Know your ACE score


We Americans certainly have health problems. But with the world’s best health technology at our disposal, we can now prolong our lives when confronted with problems like heart disease, cancer, diabetes, stroke and other maladies. It wasn’t too long ago that many of these conditions led to much shorter life spans. 

 

We’re also learning a lot about how many of these diseases are actually symptoms of deeper problems. As researchers began looking for root causes of these issues, they found that these conditions are often concentrated in parts of our country where there is a lot of poverty. They also learned that caring for individuals suffering with these symptoms is extremely expensive. And they found that increased health expenditures in these high poverty areas didn’t necessarily improve health as much as they should have. And while throwing lots of money at these problems does generate lots of business for the health care industry, there may be a better way to improve our health.

 

It turns out that a simple questionnaire called the ACE Assessment—that can be given at a visit to any clinic—can help with this problem. ACE is short for “Adverse Childhood Experiences.” The few questions on the assessment generate a score, and research shows that the ACE score correlates really well with the likelihood that someone will suffer from one or more of these symptoms. Interestingly, more than anything else, the questions on this survey ask about childhood experiences of fear.

 

Yes, that’s right: a fear assessment.

 

Incredibly enough, childhood experiences of adversity can create stress and fears that may cause diseases extending into adulthood and aging.   According to researchers, young brains are especially vulnerable to stress.  “When prolonged stress occurs during infancy and childhood, the stress hormone cortisol is released throughout the young brain and body.  These stress hormones compromise normal brain development and damage the immature immune and nervous systems.” 

 

Could it be that early stress might account for some of our troubling health problems in Big Horn County?  If so, is there anything that could be done to protect young children from the effects of poverty? 

 

A decade ago, Bonnie and I observed a village where these symptoms seemed to be nonexistent. We sat for a meal on two of the few chairs available at a kitchen table in the most important house of Cheng Meng, an impoverished Tibetan village. There was a striking contrast between obvious impoverishment and robust health present in this family, and in virtually all we met. Villagers lived in ancient buildings with dirt floors, worked very hard raising vegetables and herding goats on the mountainsides. For a little extra income they hiked into the tundra to collect “Tibetan Medicine,” to sell to middle profiteers for a burgeoning market in the cities of China. But in contrast to American poor, nearly everyone had lived for generations in the same houses, worked the same jobs, and was deeply connected with everything and everyone around them. They didn’t know they were missing fast food, grocery stores, and the constant presence of media entertainment.

 

We watched healthy, active children accompanying their families into the high country the day we visited. These youngsters obviously grew up connected and knowledgeable about their importance to everyone else in the village. Their connections fed them, warmed them, and gave them a sense of safety.  Their lives were predictable and stable. Their days were filled with love, healthy foods and challenging exercise for their growing bodies. We were surrounded in this house in this village with awesome hospitality of the healthy families there.

 

Recently I began wondering what I could learn from this encounter. Why were these people so healthy, so free of the usual American symptoms? The temptation is to look for an ingredient in the mountain air, a particular food from the tundra of the Himalayas, or a rare ingredient in the gall bladder of a Himalayan tiger. However, having learned about the ACE Study, I wonder now if I was looking for the wrong magic ingredient. Perhaps I should have considered the need for children to have stability, connection, and a solid heritage of people and place.  These basic elements provide safety and nutrition for developing brains, provided by the work of parents and extended family. Science clearly demonstrates that when these elements are lacking, illness and modern disease can become a plague.

 

To learn more, check out “The Childwise Institute,” an organization of medical providers based in Kalispell.  http://www.childwise.org/ace-study-summit-2014/

 

A PBS documentary on “Frontline” highlights the connections between poverty, high per capita health costs, and high levels of unhealthiness in a major city in the east. 

http://www.pbs.org/wgbh/pages/frontline/doctor-hotspot/

 

More ACE research and associated links:

 

Here’s how certain kinds of fears trigger health problems that often last a lifetime:

http://www.americasangel.org/research/adverse-childhood-experiences-ace-study/

 

Specific health risks were identified in the research leading to the ACE assessment, especially with children.  Read how the scoring functions, and the findings of other recent research:

http://acestudy.org/ace_score

http://www.cdc.gov/ace/findings.htm

http://www.acestudy.org/files/ACE_Score_Calculator.pdf

 

The new ACE assessment tools could have been inspired by health research in the village of Cheng Meng. They unveil the level of safety and trustworthiness of a child’s connections with friends, family, and with their world, like a thermometer and a blood pressure meter uncovers other health indicators. Assessing this connective network is being viewed now by the ACE score system in some health clinics as an equally important indicator of health. When coupled with resources and strategies to make changes toward correcting roots of human unhealthiness, we in Big Horn County as well as across our nation could really benefit at no greater cost, in fact, probably much less.  

 


--
David Graber
graberdb@gmail.com

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