2. Preparing for New Information This presentation may change how you view the world or make sense of past experiences. We encourage you to seek support and care for yourself if you become upset. The United Way 211 helpline provides peer counseling, crisis intervention, and information and referrals. Calling is free and confidential.

3. Story

4. What gives you strength?

5. A new look at addictions and unhealthy behaviors “What’s wrong with these people? Don’t they know any better?”

7. Adverse Childhood Experiences Abuse: physical, sexual, psychological Neglect: emotional, physical Exposure to other traumatic stressors: substance abuse, divorce, mental illness, battered mother, criminal behavior Study Overview

8. Study method 17,421 members of the Kaiser Health Plan in San Diego County from 1995-1997 Confidential survey asking questions about childhood trauma and current health status and behaviors combined with physical examination Demographics: primary care setting educated middle class predominantly white

9. Childhood experiences can be powerful determinants of who we become as adults. General finding

10. What it found

11. Adverse Childhood Experience tend to occur in clusters Number of ACEsThose surveyed 0 36% 1 26% 2 16% 3 9.5% 4 or more 12.5%

16. Chronic depression

17. Prevalence of heart disease in women ACE Score Percent

18. Early mortality Age Group

20. What does this mean for Iowa?

21. Prevalence of ACEs in Iowa

22. Co-occurence of ACEs in Iowa

23. Where do Iowans with ACEs live now?

24. Impact on Iowan’s lifelong health ACEs and Poor overall Health ACE-Related Number of Bad Health Days in Last Month

28. *Iowa median household income in 2012 was $50,957.

29. How can ACEs impact someone long-term?

30. The framework National Center for Chronic Disease Prevention and Health Promotion

31. A child’s brain Experiences build brain architecture

32. Impact of ACEs

33. Toxic Stress Derails Health Development Center on the Developing Child, Harvard University

37. Impact on education

42. Discussion  What are your reactions to this research?  What information resonates most with you?  How does this study relate to your field or areas of interest?

43. Now what?

44. Childhood experiences can be powerful determinants of our health and well-being as adults…. BUT THEY DO NOT HAVE TO.

47. What happened to you? vs. What’s wrong with you? Trauma-Informed Care

48. Iowa’s response

49. Opportunities to respond Take Action  Build communities in which people feel a sense of responsibility and care for one another  Integrate a trauma-informed approach across child- and family- serving systems and organizations  Advocate for services that help families build resilience, social connections, parenting knowledge, nurturing and attachment, and access to needed resources

50. Opportunities to respond Share the Knowledge  Online Learning Modules  Increase awareness of trauma and its impact with family and friends Join the Discussion  ACEs Connection-Iowa Action Group

51. How might the information shared today affect you and your work? What can be done to address ACEs in your organization or community? What opportunities do you see for using Iowa’s data next year? Who should be involved in the effort to address ACEs? What is missing from this conversation? What questions do you still have? Discussion

53. Resources ACEs Too High acestoohigh.com Centers for Disease Control and Prevention www.cdc.gov/ace Harvard Center on the Developing Child developingchild.harvard.edu Iowa ACEs 360 www.iowaaces360.org Zero to Three www.zerotothree.org