Page 28 - Sonoma County Gazette February 2020

Vulnerable: susceptible to physical or emotional harm. A person in need of special care, support, or protection because of age, disability, or risk of abuse or neglect.
Chronic illness, mental health problems, substance abuse, and homelessness seem to be spinning out of control. Sometimes there seems to be a multi-generational component to these issues. It seems almost like some kids have the deck stacked against them even before they are born.
Where Do Prevention Programs Fit into Helping Our Community?
We are starting to understand some of what is going on here, and it helps guide some potential responses to the problem. None of this is short term, though.
Why? The intractable nature of some of these problems can be staggering. How is it that people continue to make choices that hurt themselves and their families?
National research in recent years clearly shows that health disparities correlate with economic disparities. The studies demonstrate that there can be up to a 20 year longer average lifespan in neighborhoods with higher socioeconomic status compared with nearby areas that are poorer, after controlling for other lifestyle factors.
We are also learning that Adverse Childhood Experiences (or ACEs) such as living in under-resourced neighborhoods, frequently moving, having parents with emotional or substance abuse problems, and experiencing food insecurity, can cause something called ‘toxic stress’ (extended or prolonged stress). Toxic stress from childhood trauma can change brain development and affect such things as attention, decision-making, learning, and response to problems.
Children growing up with toxic stress may have particular difficulty with forming healthy and stable relationships. This may all lead to erratic work histories as adults and ongoing struggles with finances, jobs, and depression throughout life. These effects can also be passed on to their own children.
While it is easy to see how ACEs can lead to Mental Health and relationship issues, and even to substance abuse to numb out the pain, it is also clear that regular health outcomes can also be affected. Many chronic illnesses are much more likely in people with higher numbers of childhood ACEs.
Dr. Nadine Burke-Harris, the new California Surgeon General, has made this a focus of her work. You can see her on a TED talk that explores the topic: www.ted.com/speakers/nadine_burke_harris_1.
What to do? We all know how hard it is to help someone who is very sick, in jail, deeply involved in drugs, or having a mental health crisis. Understandably, acute care is where most of the health resources go. Yet, a gentler and more cost-effective approach is to try to prevent these outcomes before the behaviors get firmly entrenched.
Sure, it would be great to decrease the trauma that the children are exposed to, but I’m not sure we have the power to cure that problem. The research does show some promising things that can be done, though—basically providing programs that support the folks who are the most vulnerable.
By giving some support before the behavior and brain changes are firmly established, the long-term trajectory can be changed in a good way.
Teaching parenting skills and providing some support for young parents can help prevent outbursts from frustration, which decreases the toxic stress for the kids. Ensuring food security and housing stability helps.
WELLNESS cont’d on page 29
28 - www.sonomacountygazette.com - 2/20