Who We Are… Kids Oneida Upstate Cerebral Palsy Oneida County Planning; DSS; Health/Mental Health SUNYIT Utica College Family Nurturing Center Dr. Lark Eschelman- Patterson & Bob Patterson Peg Zimmerman Honorable Ralph Eannce Robin O’Brien – USCare Gina Ashmore – Hospice

What do we mean by Adverse Childhood Experiences? The Adverse Childhood Experiences (ACE) Study Examines the health and social effects of ACEs throughout the lifespan among 17,421 members of the Kaiser Health Plan in San Diego County What do we mean by Adverse Childhood Experiences? - childhood abuse and neglect growing up with domestic violence, substance abuse or mental illness in the home, parental discord, crime

Goals Of The Local Efforts: Reinforce awareness Linking ACES to physical and mental health To ascertain perceived needs in the community and collect information on who professionals are referring to now To solicit help and recommitment for the vulnerable youth in Oneida County

What Are ACES (Adverse Childhood Experiences) Emotional/Physical Abuse Sexual Abuse Emotional/Physical Neglect Domestic Violence – Battered Mother Single Parent Homes – Due to Separation/ Divorce/Death Substance Abuse - One or Both Parents Incarcerated Parent(s) Parent(s) Suffering From Mental Illness Parent(s) Suffering From Chronic Illness

Adverse Childhood Experiences Are Common Household dysfunction: Substance abuse 27% Parental sep/divorce 23% Mental illness 17% Battered mother 13% Criminal behavior 6% Abuse: Emotional 11% Physical 28% Sexual 21% Neglect: Emotional 15% Physical 10%

Health-risk Behaviors Adverse Childhood Experiences Death Early Death Disease, Disability and Social Problems Scientific gaps Adoption of Health-risk Behaviors Social, Emotional, & Cognitive Impairment Adverse Childhood Experiences Conception What We Know

ACEs tend to come in groups… Additional ACEs (%) 1 2 3 4 >5 If you had: A battered mother 95 82 64 48 52

Adverse Childhood Experiences Score Trauma “Dose” Number of individual types of adverse childhood experiences were summed… ACE score Prevalence 0 33% 1 26% 2 16% 3 10% 4 or more 16%

Frequency of witnessing Prevalence of Childhood Abuse by Frequency of Witnessing Domestic Violence 100 Frequency of witnessing domestic violence 80 Never Once,Twice Sometimes Often 60 Very often Percent (%) 40 20 Emotional Physical Sexual Childhood Abuse

ACEs, Smoking, and Lung Disease

ACE Score and HIV Risks Ever Had an Had 50 or More Ever Injected STD Drugs Had 50 or More Intercourse Partners

The ACE Score and the Prevalence of Severe Obesity Percent obese (%) ACE Score

The ACE Score and the Prevalence of Liver Disease (Hepatitis/Jaundice) Percent (%) ACE Score

The ACE Score and the Prevalence of Attempted Suicide Percent atempted (%) ACE Score

The ACE Score and a Lifetime History of Depression Percent depressed (%) ACE Score

ACE Score and the Risk of Being a Victim of Domestic Violence Women Men 15 10 Risk of Victimization (%) 5 0 1 2 3 4 >5 0 1 2 3 4 >5 ACE Score

ACE Score and Rates of Antidepressant Prescriptions (per 100 person-years) Prescription rate 0 1 2 3 4 >=5 ACE Score

ACE Score and Rates of Prescribed Antidepressant Medications by Age, 1997-2004 Relative rates are adjusted for age, sex, race/ethnicity, and education. Adults with an ACE Score of 0 are the referent. ACE Score 45-64 yrs 18-44 yrs 65-89 yrs

Adverse Childhood Experiences As a National Health and Economic Issue ACEs have a strong influence on: -adolescent health -reproductive health -smoking -alcohol abuse -illicit drug abuse -sexual behavior mental health risk of revictimization stability of relationships, homelessness performance in the workforce

Adverse Childhood Experiences As a National Health Issue ACEs increase the risk of: Heart disease Chronic Lung disease Liver disease Suicide - Injuries HIV and STDs and other risks for the leading causes of death

The Adverse Childhood Experiences (ACE) Study - These strength of these findings indicate that: Adverse Childhood Experiences are a leading determinant of health and social well-being of from adolescence to late adulthood ACE Study website www.cdc.gov/nccdphp/ACE

Adverse Childhood Experiences Rarely Occur in Isolation… They come in groups.

Domestic Violence and the Risk of Other ACEs...

ACEs and Prescriptions for Antidepressant Medication

ACEs and the Risk of Domestic Violence as an Adult.. A Cycle…

Study on Adverse Childhood Experiences 9/07 Kids Oneida Study on Adverse Childhood Experiences 9/07

*3 or less indicators: 28% *4 or more indicators: 72%

*3 or less indicators: 30% *4 or more indicators: 70%

*3 or less indicators: 21% *4 or more indicators: 79%

Number of Open Cases 9/07 = 120 Studied

Of Interest: * ACE Study 14% had 4 or more ACE Indicators *ACE Study : 1 in 10 had 5 or more ACE’s *More common for indicators to occur in groups *Higher ACE score leads to health risks: -more alcohol abuse/alcohol related health issues -more tobacco-related health issues -higher risk of illicit sexual behavior and STD’s -higher risk of suicidal ideation/depression - Huge increases in cost over a a life time

Body Stress System

Stress Illness Relationships Taken from Taylor, 2006

Stress Illness Relationships Taken from Taylor, 2006