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If You Want Better Fruit, You've Gotta to Deal with Roots

 
 
Pair of ACE's Tree
 
The Pair of ACEs tree illustrates the influence of a community environment on the lives of children and families in New Orleans. Specifically, the Pair of ACEs tree depicts the interconnectedness of adverse community environments (ACEs)—the soil in which some children’s lives are rooted—and the adverse childhood experiences (ACEs) of their family environment, or branches on which children bud and grow. 
 
New Orleans has a childhood trauma problem that has persisted over time and has gone under-recognized and untreated. The problem may have formed and been compounded through the combination of ACEs often occurring in adverse community environments. Childhood trauma in New Orleans may often be thought of using the standard lens of a medical model that usually focuses on treatments for the patient with the presenting issues. However, the communities of New Orleans are traumatized too and represent a critical part of this city’s childhood trauma problem. Traumatized communities are more than a collection of traumatized individuals. Rather, they are communities that have a history of disenfranchisement and oppression and that disproportionately carry the burden of structural violence, which means a social structure that perpetuates inequity and causes preventable suffering or trauma.
 
The Pair of ACEs tree identifies social structures or systems, as reflected in the soil, that can have a disproportionately negative impact on the lives of people who live in communities suffering from systemic inequities. Specifically, the social structures or systems can be identified as: economic, educational, legal, medical, and political. 
 
Building Community Resilience
 
The George Washington University, School of Public Health Building Community Resilience (BCR) Initiative’s research informs the existence of ‘Inequity by Design.’ BSR finds that adverse community environments are the result of policies and practices across multiple systems that were perfectly designed for the place- based inequities they produce. New Orleans’ poor live in communities of concentrated poverty not by choice, but rather by design—the cumulative result of social and criminal policies enacted over the course of the City’s 300-year history. For example, federal policy and lending practices in the real estate industry in the early 20th century supported housing segregation that persists today (e.g., redlining, restricted covenants preventing property transfer based on race, gentrification, sub-prime mortgages, etc.). 
 
These policies combined with the inequitable enforcement of policies across criminal justice (enforcement, mass incarceration, etc.) and public education (funding levels, zero tolerance, decentralization, etc.) also help to explain the place-based differences in who is arrested, the length of incarceration, and the odds of attending a high- performing school, completing high school, attaining higher education, or entering the skilled trades by way of trade union apprenticeships. 
 
The New Orleans Pair of ACEs tree is planted in soil that is steeped in systemic inequities and dysfunction, robbing it of nutrients necessary to support a thriving community. Adverse community experiences, such as lack of opportunity, limited economic mobility, fear of discrimination, and the associated effects of poverty and joblessness, contribute to—and compound— the adversities that children and families experience. If the soil is improved through investments in economic development, affordable housing, or educational opportunities, for example, the branches on the tree will grow stronger, yielding healthier leaves. This will translate into improved and measurable outcomes such as increased kindergarten readiness, increased high school graduation rates, lower crime rates, increased economic mobility for children and families, and a sharp decline in the prevalence of childhood trauma.

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