On World Health Day, Let’s Beat ACEs
Every year, on World Health Day, the World Health Organization rallies the global community around a serious public health threat. This year, on April 7, the World Health Organization is uniting behind the call to “Beat Diabetes.” And with good reason. Nearly 350 million people around the world have diabetes, and in the United States, more than 29 million people have diabetes. The consequences of diabetes can be severe. Diabetes can lead to kidney failure, amputation and blindness, and increases the risk of heart disease, stroke and death.
The prevalence of diabetes is concerning and it’s vital that communities across the nation and the globe work to stem the epidemic. Some of the most commonly discussed risk-factors for developing diabetes are unhealthy dietary and exercise habits and body weight. While these are critical, at the Center for Youth Wellness, we are concerned with the link between diabetes and another emerging public health threat – exposure to adverse childhood experiences (ACEs).
Adverse childhood experiences like abuse, neglect and household dysfunction are common, and are linked to serious, long-term health outcomes. In California, 61.7% of adults have experienced at least one ACE as a child and 16.7% of adults have experienced four or more ACEs (PDF). Research shows that adults exposed to four or more ACEs as children are 1.6 times as likely to have diabetes (PDF). It doesn’t stop with diabetes. People exposed to early adversity are also more likely to develop ischemic heart disease, stroke and chronic obstructive pulmonary disease, otherwise known as the top three global causes of death in 2012. Given the prevalence of ACEs, we know a lot of children have a greater likelihood of developing diabetes and other serious illnesses in adulthood.
But why would early adversity lead to diabetes later in life? The answer is toxic stress. Stress becomes toxic when a child experiences intense, prolonged and repeated exposure to stress without interventions, such as a buffering adult. Toxic stress disrupts the normal stress response system (PDF), flooding a child’s body with unhealthy levels of cortisol – the hormone central to the long-term stress response system. Too much cortisol increases blood pressure and blood sugar and weakens the immune system. This biological disruption is linked to a child’s increased likelihood of developing diabetes and other illnesses as an adult.
The link between ACEs and some of the world’s most pressing global health challenges reinforces that ACEs themselves are a serious public health threat. Without intervention, a child exposed to ACEs is more likely to become another adult facing health problems like diabetes, heart disease, cancer and more. And collectively, each of these adults whose health has been negatively impacted by ACES will contribute to the nation’s and world’s greatest public health burdens.
We can change the trajectory from early adversity to poor health if we step up to address the true public health threat that ACEs represent. It starts with the same screening principle that physicians deploy to detect diabetes risk. At CYW, we believe every child should be screened for ACEs in the pediatric setting. And just like someone who’s been identified as at risk for diabetes by a screening tool, a child with a high ACEs score should be offered treatments that research shows may reduce their health risks.We can beat diabetes and other diseases, and improve health outcomes for children. It starts when we commit to beating the effects of ACEs.