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When ACEs collide with Social Adversity and Disparities


When ACEs collide with additional social adversity outside the home, our children and youth can face daunting challenges. Social adversity in the form of community violence or growing up in areas where isolation and poverty are the norm, rather than robust services and opportunities, can also diminish every family member. 

Far from the public eye, academics and health researchers use terms to describe various forms of social adversity. There’s an entire field of study focused on the social determinants of health which documents how the conditions we raise our children in have a profound impact on our physical, emotional and intellectual lives. We can ensure far more safe and healthy childhoods by investing in robust communities with family-friendly services. Otherwise we accept a status quo that imperils children. 

Related to the social determinants of health is a term that is often used in health policy circles: health disparities. This is defined as lack of similarity or equality or simply put: inequality and difference within the healthcare system. Some folks get great care, others, not so much, or none at all. 

Disparity after Disparity

We can use the term education disparities to describe our vastly different systems of public education where some students soar and others are marginalized and ignored. 

There is another term we use in this book: opportunity disparities, i.e. all the experiences that enrich our lives. Imagine for a second a fourteen-year-old named Eric, living in a home where ACEs are the norm and resources are few. Because Eric and his counterparts in those troubled and under-resourced zip codes are missing out on all sorts of opportunities like living in a home that’s calm and stable, rather than chaotic with the constant threat of violence. He also misses the opportunity to take a Saturday workshop on web design, or a caring mentor who takes him out for burgers on the weekend to talk about his hopes and dreams, or any help from a tutor with his high school studies, let alone anyone who might bring up the idea that he might attend college. 

Eric will never have a vacation to Disneyland or the Grand Canyon for raising his grades. He might not even have a single day when he strolls home from school and isn’t fearful of getting assaulted. And of course this lack of opportunity extends to Eric’s mother, who may never have a single hour of peace as she spends all her energy working full time and caring for her four children. Even Eric’s stepdad, who is working two jobs, may only know a life of exhaustion and frustration. 

Our goal with the "100% Community" Trauma Prevention initiative here in New Mexico is to keep social adversity to a minimum, and instead create community environments where children, students and families thrive. Our Anna, Age Eight Institute is committed to ensuring that every child can thrive, not just the privileged middle class and upper class elite.

Choosing thoughtfully 

We all have a choice to make. We can commit to the success of families, students and communities, or we can pay for the costly social consequences with every form of dysfunction that we say we wish to avoid: substance misuse, violence, school dropout, homeless people with untreated mental health challenges and underemployment. With enough dysfunction left to simmer for decades, we end up with entire communities that are traumatized, lacking an economic engine to sustain its residents with jobs. 

What we are sharing here is far from new. Amazon has 1000+ books on trauma related to ACEs, most of which approach the issue from a behavioral health care provider perspective. There is no question that traumatized people can benefit greatly from an effective counselor. Yet counseling alone won’t end the challenges of someone facing social adversity from a wide range of sources with few resources to fall back on. That’s why we need to go back to services for surviving and thriving to counter social adversity. 

We don't lack for information

While the nation’s universities have done an excellent job of documenting our social problems in all their destructive forms, few have become centers for the data-driven prevention of childhood trauma and social adversity. While the world wide web is filled with literally millions upon millions of articles on how to fix any social challenge anytime, anywhere, almost no organization in any state has harnessed this vast wealth of insights to eradicate childhood trauma and disparities as we did smallpox and polio. 

Meaningful action vs. illusion 

So now, twenty years after the ACEs Study was published, we say loudly, “Enough is enough.” Enough with the tepid prevention response. Enough with posts on LinkedIn, Facebook and other social media that note problems but aren’t advocating for data-driven solutions. Enough with strategic plans from governments and foundations that fail to commit to ending their root causes in a systematic manner. Enough with slick PR campaigns and websites that claim to be working toward solutions, but if you scratch their surfaces you find that there’s no measurable, nor meaningful strategy. 

We are far too weary to hear our leaders claim that “our children are our priority” but offer no significant or sustainable funding to truly commit to the cross-sector change that’s needed. As for our monolithic media companies that market themselves as the voice of reason and progress, please stop numbing us with disconnected clutter. Lastly, can we all agree to retire the sentiment, “Trauma is just too big and complex to fix.”

Ending the epidemic of trauma and social adversity diminishing the lives of our children, students and families is doable. ACEs, trauma and disparities are predictable and preventable. After years of research, we have the data-driven plan to ensure trauma-free and thriving childhoods. We are eager to share our challenges and successes with you. 


Dominic Cappello is the co-author, with Katherine Ortega Courtney, PhD, of Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment and 100% Community: Ensuring trauma-free and thriving children, students and families. and

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Most, if not all, of the ten original adverse childhood experiences are associated with unsupportive, harmful parenting.  What is your plan to elevate and level the overall quality of parenting in communities?

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