Transcript Community

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Reversing the Tide
Proven strategies to reduce the
individual, community & business
risks fostered by adverse
childhood experiences
DRAFT
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Today we’ll gain knowledge, skills &ideas:
To ensure that people in our community—including those facing
major life challenges—have joyful, productive and fulfilling lives;
And improve the profitability of businesses in our community.
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The Way You Spend Your Days Matters
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“Our prime purpose in this life is to help others. And if
you can't help them, at least don't hurt them.” -Dalai Lama
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Pathway to Improved Quality of Life
Childhood
Experience/
Stressors
Development
& Health of
Brain & Body
Emotional
& Intellectual
Achievement
Home, Work
& Community
Life
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The Brain’s Developmental Sequence
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Examples of Developmental Outcomes
Middle Childhood
• Connection between hemispheres
• Multi-modal problem solving
• Understanding social cues
Adolescence
Early
Childhood
•Self-regulation
•Production of
happy hormones
•Verbal memory
•Regulation/ dysregulation of
mental health
• Executive
function
• Sound judgment
• Understanding of
consequences
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Brains to Fit the Life We Live
Toxic Stress
DEVELOPMENT
INDIVIDUAL
for a tough life:
characteristics
& traits
• Emotion processing regions
smaller, less efficient
• Efficient production of stressrelated chemicals
• Dysregulated happy hormones
• Fewer receptors for calming
• Less white matter
Neutral Start:
All brains are
made to adapt
• Competitive
• Hot tempered
• Impulsive
• Hyper vigilant
• “Brawn over
brains”
INDIVIDUAL
characteristics
& traits
DEVELOPMENT
for a good life:
• Emotion processing regions
robust and efficient
• Abundant happy hormones
• High density white matter,
especially in mid-brain
• Laid back
• Relationshiporiented
• Reflective
• “Process over
power”
WHY IT
WORKS
Under the worst
conditions, such
as war & famine,
both the
individual & the
species survive.
WHY IT
WORKS
By striving for
cooperative
relationships,
individual &
species live
peacefully.
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Socially & Economically Valued Skills
INDIVIDUAL
characteristics & traits
• Competitive
• Hot tempered
• Impulsive
• Hyper vigilant
• “Brawn over
brains”
• Brainstorm: What kinds of
jobs are a good fit? Why?
• What knowledge and skills
would a young person need
to develop to be successful
at those jobs?
• What kind of learning
environment would best
support a young person in
acquiring the needed
knowledge and skills?
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Adverse Childhood
Experiences Study:
Physical, Mental & Behavioral
Health Built by Experience
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The Adverse Childhood
Experiences (ACEs)
1. Child physical abuse
2. Child sexual abuse
3. Child emotional abuse
4. Neglect
5. Mentally ill, depressed or suicidal person in the home
6. Drug addicted or alcoholic family member
7. Witnessing domestic violence against the mother
8. Divorce or parental separation
9. Incarceration of any member of the household
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Response gets bigger
Dose-Response Relationship:
More ACEs = More Disease
Dose gets bigger
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Higher ACE Score Increases Smoking
6 of 100 people with 0 ACEs smoke
11 of 100 people with 3 ACEs smoke
17 of 100 people with 7 ACEs smoke
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High ACEs Creates Pathways to Lower
Quality of Life: High Risk of Poverty
Toxic
Stress
Poor Health:
• Chronic Illness
• Attention,
Emotional &
Behavior Issues
Trouble:
• School Failure
• High Risk Sex
• Relationship
Issues
High Risk for:
• Mental Illness
• Substance Abuse
• Incarceration
Poverty
Jobless
Homeless
Alone
Hopeless
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Life-long Physical, Mental & Behavioral
Health Outcomes Linked to ACEs
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Alcohol, tobacco & other drug addiction
Auto-immune disease
Chronic obstructive pulmonary disease & ischemic heart disease
Depression, anxiety & other mental illnesses
Diabetes
Multiple divorces
Fetal death
High risk sexual activity, STDs & unintended pregnancy
Work problems—including absenteeism, productivity & on-the-job injury
Intimate partner violence—perpetration & victimization
Suicide attempts
Liver disease
Lung cancer
Obesity
Self-regulation & anger management problems
Skeletal fractures
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ACE Score Increases Suicide Attempt
1 of 100 people with 0 ACEs attempt suicide
10 of 100 people with 3 ACEs attempt suicide
20 of 100 people with 7 ACEs attempt suicide
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If our community
really understood how
ACEs get wired into
biology, what might
change? What are a
few things our
community might do
differently to help
everyone have more
joyful, fulfilling &
productive lives?
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ACEs and Disability in Washington
84.2% of Washington adults experienced no
disruption to daily activity in the last month due
to disability
9.1% disabling condition + 1-15 days disrupted activity (LOW)
3.2% disabling condition + 16-29 days disrupted activity (MODERATE)
3.5% disabling condition + 30 days disrupted activity (HIGH)
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Prevalence of ACEs:
ACE Study & Washington State BRFSS
ACE Study
Washington BRFSS
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“Muscles aching to work, minds aching to
create - this is man.” –John Steinbeck, The Grapes of Wrath
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ACEs & Disability
Child
Abuse
High ACE
Score
High ACE
Score
Permanent
Disability
Permanent
Injury
Substance
Abuse
On-the-Job
Injury
Anxiety, Depression,
Other Mental Health
Disorder
Temporary
Disability
from Work
Intermittent
Disability
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Unemployment (%)
Lost Time Doubles Risk of Unemployment
over Disability Alone
No Disability
No Lost Time
Disability
No Lost Time
Disability
Any Lost Time
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For the most part, resilience is
about the positive day-to-day
ways we interact with, support
and help each other.
How might we go about making
fostering resilience a key
component of leadership in our
community?
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Resilience is the ability to “meet challenges, survive
and do well despite adversity” –Kirmayer, 2009
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Unemployment: Lost Days & Resilience
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% Unemployed
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Low (1-15) Lost Days
Moderate (16-29) Lost Days
High Resilience
High (30 of 30) Lost Days
Low Resilience
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% Unemployed
Unemployment: ACEs by Resilience
High Resilience
Low Resilience
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Unemployment by ACE
& Days Able to Do Usual Activities
Unemployment Rate (%)
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10
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No Lost Days
Low (1-15) Lost Days
0-2 ACEs
Moderate (16-29) Lost Days
3+ ACEs
High (30 of 30) Lost Days
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Community Capacity - The ability of community members to use the assets of their
community, e.g. residents, associations and institutions, to improve the quality of life for
those living in the community. Each community's collection of assets is unique and
reflects the specific characteristics of its population, its political structures and
geography.
Community capacity is defined as “the combined influence of a community’s
commitment, resources, and skills that can be deployed to build on community
strengths and address community problems.” A variety of individuals, families,
community groups and institutions contribute to community capacity. Each is a
potential partner in the work of strengthening the viability and vitality of communities.
In partnership, each can gain in capacity.
Community capacity is the interaction of human, organizational, and social
capital existing within a given community that can be leveraged to solve
collective problems and improve or maintain the well-being of a given
community. It may operate through informal social processes and/or
organized efforts by individuals, organizations, and the networks of
association among them and between them and the broader systems of
which the community is a part.
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High Community Capacity, High Social/Emotional Support
Ages 18-34, 3-8 ACEs
% Reporting Social/Emotional Support
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
Always/Usually Have Support
Sometimes
Frequency of Social/Emotional Support
Low Capacity
High Capacity
Rare/Never
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Serious Mental Illness & Community Capacity
Ages 18-34, 3-8 ACEs
50.00%
% Reporting Mental Illness
45.00%
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
Serious
Mental Illness
Severe
Depression
Depression
Low Capacity
High Capacity
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Factors that contribute to resilience include:
•Close relationships with family and friends
•A positive view of yourself and confidence in your
strengths and abilities
•The ability to manage strong feelings and impulses
•Good problem-solving and communication skills
•Feeling in control
•Seeking help and resources
•Seeing yourself as resilient (rather than as a victim)
•Coping with stress in healthy ways and avoiding harmful
coping strategies, such as substance abuse
•Helping others
•Finding positive meaning in your life despite difficult or
traumatic events
This Emotional Life is a co-production of the NOVA/WGBH Science Unit and Vulcan Productions, Inc. A Film by Kunhardt McGee
Productions. ©/™ 2009 WGBH Educational Foundation and Vulcan Productions, Inc.
All Rights Reserved.
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Psychologists Richard G. Tedeschi and Lawrence Calhoun have
found in many cases that reports of growth after traumatic events
far outnumber the reports of disorders.
They describe five areas of growth reported by people who have
experienced traumatic events:
Discovery of new opportunities and possibilities that were not present
beforeCloser relationships with others, especially others who sufferGreater appreciation for lifeGreater sense of personal strength: “If I lived through that, I can face
anything”Spiritual growthWe need to understand and remember that growth comes from
the struggle to cope with the trauma—not from the event itself.
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“Rugged individualism” is a
stereotype in American culture, and a
myth. Resilient people are
resourceful, and friends and family
are among their most important
resources. Resilient people have
strong social networks, close
connections to family and friends, are
able to self-disclose about their
troubles to people close to them, and
ask for help when they need it.
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Community Capacity Building
Recognition and Inventory of Existing Assets
Cultural and Historic Heritage
Health and Well Being
Economic Opportunity
Sustainable Environment
Community Services and Infrastructure
Social Networks and Civic Engagement
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Community Capacity Development
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Next Steps
Make a time and a space for our community to:
▫ Learn about ACEs and
▫ Generate ACE-informed solutions to ACE-related problems
Use the strengths of many to improve resilience among adults with high ACE
scores, such as:
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Generating accommodations for normal response to toxic stress,
Reducing trauma triggers in schools and the workplace,
Promoting healthy social networks at work
Supporting employees in developing skills and habits that are transferable to great
parenting – especially the kind that will prevent ACEs in the next generation
Lead efforts to develop community capacity, for example, by:
▫ Participating in, co-leading or convening community dialogues addressing issues
that matter the most to us
▫ Learning together
▫ Initiatives to expand leadership in generating community solutions
▫ Lending expertise and time to help community leaders become results-oriented
and to measure results
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Thank you!
• Skamania Klickitat Community Network
Building strong, healthy communities
• 1-866-631-1997
• http://community.gorge.net/skcnparentsupport
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http://vetoviolence.cdc.gov/childmaltreatment/phl/resource_center_infographic.html