A tale of two counties: Childhood trauma and health in California

Traumatic childhood experiences, also referred to as Adverse Childhood Experiences (ACEs), are shown to critically impact the health outcomes of adults later in life. These traumas, including abuse, household dysfunction and neglect, can lead to health issues such as depression, chronic pulmonary disease, and early death. With each instance of trauma a person undergoes before age 18, their ACE “score” goes up by one point.

The landmark study on ACEs, released in 1998, showed ACEs to be a leading determinant of health and social well-being. This study, done by the Centers for Disease Control and Kaiser Permanente, reveals that if any one ACE is present, there is an 87 percent chance a person will have experienced another ACE, and a 50 percent chance that three others are present. Women are 50 percent more likely than men to have high ACE scores.

In recent years, new studies confirm the correlation between ACEs and long-term health issues. Research shows that ACEs are common, and are clustered in certain areas. Within California, there is an incredible variation in ACE scores, from lows in San Francisco County to highs in Butte County.

I’m proposing a series of stories about ACEs for KQED public radio and web.

The first of these stories will profile an adult in Butte County who experienced a high number of ACEs as a child and now struggles with serious health issues. This story will introduce listeners to the concept of ACEs, to the disparity of ACE scores statewide, and look into theories as to why ACE scores are clustered.

The second story will take a comparative look at San Francisco and Butte Counties, focusing both on the factors that lead to Butte’s alarmingly high rate of ACEs (over 30 percent of people report four or more ACEs) and to San Francisco’s relatively low rate (just 9 percent report four or more ACEs).

The third story will focus on what public health departments, schools, medical professionals, nonprofits, and research institutions are doing to address ACEs and build resilience among Californians. I will look at programs in San Francisco and Butte Counties that are addressing childhood traumas and have seen promising outcomes.

Finally, I’m hoping to engage our listeners through social media call-outs about childhood trauma they’ve experienced and practices they follow to build their own resilience — these can be daily exercises or a specific past event or program. I will compile these responses into a final story that will be a series of quotes and images about the resilience regimen of Californians.

I’ll be looking at the most recent data I can find about ACEs in California, in addition to newly released research on this topic. This work will further my ability to report on rural communities and to better understand resilience as it relates to health.

[Photo by Daniel Arauz via Flickr.]