How one reporter traced a community’s health problems to widespread childhood trauma

Humboldt County sits along the Northern California coast, tucked inside majestic redwood forest. The rural county looks idyllic, but residents endure more than their share of challenges.

The county has high rates of drug and alcohol abuse, the state’s highest rate of students receiving special education services, and a child abuse and neglect report rate 60% higher than the state average. Students are suspended at 1.5 times the rate in the rest of California.

Although county officials and community organizations have tried to mitigate these and other disparities, it wasn’t until a 2014 Center for Youth Wellness (CYW) report that they broadened their understanding of why such disparities exist.

The report described the biological effect of constant exposure to traumatic experiences, known as adverse childhood experiences, or ACEs. Researchers have identified 10 of these harmful childhood experiences, dividing them into three broad categories: abuse, neglect and household dysfunction.

The report found that a chronic imbalance of cortisol, the stress hormone, affects growing bodies, which eventually leads to poor behavioral and health outcomes. A person with four or more ACEs is 5.13 times as likely to suffer from depression, 2.42 times as likely to have chronic obstructive pulmonary disease, 2.93 times as likely to smoke, and 3.23 times as likely to binge drink. If those stressors aren’t buffered, they may create a generational cycle of trauma.

The report also quantified ACEs in each county of the state. Humboldt County (along with Mendocino County) residents had exceptionally high rates of ACEs: 75 percent of residents in both counties had experienced at least one ACE, while 30 percent had three or more.

When the report was published, Humboldt County leaders and community organizations began implementing services to address the impacts of ACEs.

My editor and I were brainstorming health story ideas for the 2020 California Fellowship when ACEs stood out to me. I first heard the phrase three years ago, when I worked at a summer camp in Humboldt County with children who had been exposed to extremely traumatic experiences and needed trauma-informed environments. The camp counselors were trained in reflective, rather than reactive, disciplinary techniques — one of the many interventions to address ACEs. The term ACEs was used to describe the kids’ experiences, but I wasn’t entirely sure what it meant and how it affected our community until I read the CYW study.

After researching ACEs a bit more and finding out how many local organizations had implemented new services, I decided to focus my California Fellowship project on understanding ACEs and how that knowledge can help build a healthier community.

Although the term ACEs was coined in 1998 by the Centers for Disease Control and Prevention and Kaiser Permanente, ACEs intervention is fairly new. Learning about it for my project was tough. All I had was my initial reporting on the topic, and I was confused about the various strategies for ACEs intervention. My initial sources were experts in ACEs intervention and used specific terms and lingo. It took me a few months to really understand what goes into addressing and preventing ACEs.

To reporters exploring an emerging topic, I suggest asking your sources to talk to you in really simple terms and to define those you don’t understand thoroughly. Repeat the definition back to them to make sure you understand it.

Humboldt County organizations implemented many new services, which is where I struggled a bit more with my project.

I had hour-long interviews with about four organizations, asking them how their new service addresses ACEs and helps county youth, but I found it overwhelming. I wanted to write about everything I learned and didn't want to leave out anything or anyone. I dumped it all into my first draft and lost sight of the narrative.

The narrative was the most important aspect that I had been struggling with from the beginning.

My project was about childhood trauma, abuse and neglect, experiences that people might be uncomfortable sharing. I couldn’t see how I would be able to highlight the new services without a person my readers could follow through the story.

I knew it would be difficult to find someone with a high ACE score who was willing to talk about their trauma. It's a taboo topic, something you don't generally ask or talk about.

But I did find professional sources, people working in organizations that implement ACEs interventions. With the help of my editor, Thad Greenson, I learned I could find a narrative in these sources.

To those of you who are new to journalism, as I am, and learning how to write about difficult topics, I suggest finding a narrative through the professional sources in your story. Ask what brought them to the work they’re doing. Go above and beyond in your questions to try to understand why they do what they’re doing, and you might find what you weren’t expecting.

I learned that some of my sources had come from trauma, but I realized I didn't want to focus on what had happened to them. I wanted to focus on how the trauma changed the trajectory of their lives and work.

After finding a narrative, my editor and I decided to focus on a couple of programs instead of highlighting all of them.

To those of you struggling to find a focus for your project, I suggest consolidating it. Find a couple of things that work. If you have done a lot of reporting and interviews that you aren’t going to use, that’s all right. Getting different perspectives can enrich your understanding and help you write with more authority and insight.

Another challenge I faced was finding data points on ACEs. Besides the CYW 2014 study (and because understanding ACEs is new), California doesn’t have substantial data on the topic. There isn’t a database with clear numbers on people with ACEs, so instead I looked into data sets of the impacts of ACEs, such as health and education disparities.

I looked at: kidsdata.org, California Healthy Kids and California Department of Education. 

To find out how often Humboldt County students are suspended, I went to the state’s website for these rates. When I couldn’t find data for the most recent year, I went straight to the school and asked for the numbers. It was a good reminder to track down data directly from the source, when a state system comes up short. In my case, the school’s principal was able to give me the numbers.

This is just the beginning of the county’s effort to address and prevent ACEs. While it continues creating programs and services, I hope to continue reporting on them.