The Joplin Globe editorial, “Adverse childhood experiences are an epidemic in our area,” (Nov. 13) correctly points to the significant downstream effects of adverse childhood experiences on health in Southwest Missouri.

However, the problem exists throughout the state — no community is immune from the influences of ACEs.

The link between childhood adversity and struggles in adulthood has been conventional wisdom for centuries. Frederick Douglass famously stated, “It is easier to build strong children than to repair broken men.”

Unfortunately, research to quantify the causes of strength in childhood and the extent of repair needed in adulthood was lacking. Without a definition of ACEs, better research on their influence on long-term health and coordination of community resources to reduce their effect, there is little hope of ensuring the former or moderating the latter.

Researchers from the Centers for Disease Control and Prevention and Kaiser Permanente conducted the first scientific study on ACEs and their effect on individual health and well-being in adulthood. Approaching the problem from an academic point of view, they developed a survey to evaluate adult risk behavior, health status and disease against the presence of childhood experiences across several domains. The researchers reviewed adults for psychological, physical or sexual abuse; witness of mother’s violent treatment; and household members with drug or alcohol use disorder, mental illness, or history of incarceration. The study found strong, quantifiable associations between the number of ACEs present and each adverse health and well-being measure evaluated in adulthood.

The original research and subsequent work established that ACEs produce a lifelong chain reaction of diminished physical and emotional well-being. In addition, ACEs compound — the risk increases substantially with the number of ACEs the individual endured. From near to long-term, ACEs result in social, emotional and cognitive impairment; adoption of risky behaviors; disease, disability and social problems; and premature death.

We now know that children experiencing abuse, neglect, a troubled home or toxic stress carry the burden for a lifetime. However, researchers found another troubling aspect — ACEs actually alter the physiology of a child’s brain.

Mitigating the harm of ACEs requires communities to identify the drivers of long-term health and social problems, and build communitywide systems to better serve children at risk for ACEs.

The Missouri Hospital Association and Kansas Hospital Association joined together to analyze risk in communities throughout the two states. With a risk assessment, communities can deliver the most appropriate ACE-reducing initiatives using limited resources effectively.

ACEs often manifest in the health care system. However, the causes are upstream from the clinical environment. The solution is community resilience. Resilience initiatives align and leverage community-based resources to maximize residents’ ability to cope with adversity.

Community-based systems that address the factors in the home and child’s environment that lead to ACEs are the “prevention” approach to the high social and physical costs of ACEs. Reducing this problem upstream of the health care system will reduce costs and improve lives. That makes sense for kids and adults.

Mat Reidhead is vice president of research and analytics for the Missouri Hospital Association.

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