Written by Wendy R. Ellis DrPH (c), MPH; Co-Principal Investigator & Project Director, Building Community Resilience Collaborative; Sumner Redstone Global Center for Prevention & Wellness; George Washington University
Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.
In every city, in every community and on every block, an American family struggles with adversity. That’s the thing about adverse childhood experiences (ACEs)—they have no boundaries. ACEs transcend race, class, religion, and economic status. They include experiences ranging from extreme poverty or family problems, to experiencing violence, abuse, and discrimination. While the prevalence of ACEs across all demographics are a fact, using hard data to demonstrate the impact in your community strengthens the case for action. In Building Community Resilience (BCR), we know that stories matter as does using the data to demonstrate real needs and opportunities for change.
In the BCR collaborative we aim to help organizations build coalitions to prevent, identify, and address what we call the “Pair of ACEs”—adverse childhood experiences in the context of adverse community environments (including community violence, lack of access to employment or safe places to play). We have learned the power of highlighting ‘real people’ in the community to tell the story of the Pair of ACEs—such as a grandparent’s struggle to care for a grandchild who has lost parents to heroin abuse or a parent’s incarceration, and children witnessing community violence. Data helps us better understand and describe these individual stories, the adversities experienced by children, their families, and communities. Providing data to support the narrative will help to persuade systems and agencies – from education to county officials to health systems – to make change.
For example, Ohio’s heroin epidemic has been widely covered in local and national news. Images of parents passed out in the front seat of a car while a helpless child is left strapped in a car seat made national headlines last year. While these images are shocking, it is hard to form a response to a single news story—but putting this incident in the larger context with statistics that are meaningful to local and state stakeholders can spur action. Such as the following:
- Ohio was #1 in the nation for opioid deaths (2,106) in 2014. *Kaiser Family Foundation
- In 2016, a record number (3,050) died from drug overdoses. *Ohio Department of Health
- Unintentional fatal drug overdoses cost Ohioans $2 billion in medical and job losses. *Ohio Injury Prevention Partnership
- Three Ohio cities are ranked in the top 10 across the country for highest overdose rates: Dayton (#1), Cincinnati (#6) and Toledo (#10). *www.arrest.com
- Nearly 7,000 children are in protective foster care in Ohio because of their parent’s drug addiction. *Public Children Services Association of Ohio
In Cincinnati, the BCR team has been using publically available statistics such as these as well as other key indicators to help other sectors such as juvenile justice, public health, family services, education, health care and local government understand the widespread and local impact of ACEs. The above statistics are startling, but perhaps more pertinent for local leaders is understanding the collective impact of ACEs in their own jurisdiction. For this reason, BCR partnered with the Child and Adolescent Health Measurement Initiative (CAHMI) to develop fact sheets that demonstrate the widespread impact of ACEs on families in the Cincinnati area. As you can see in the graphic below, the data demonstrate the wide variety of adversity experienced by children in comparison to the rest of the nation, state, county and neighboring Kentucky.
Understanding how children in Cincinnati and Hamilton County measure up compared with the rest of the nation may help to prioritize a response. As illustrated, city leaders, providers and community organizers are able to see that nearly one-third of children in Cincinnati compared to one-quarter nationally live in extreme economic hardship. In addition, an alarming number of children in Cincinnati (1 in 5) have witnessed or been a victim of neighborhood crime a number that is more than twice the national average.
To learn more about BCR tools and resources go to our website at go.gwu.edu/BCR. You can also learn how to create synthetic estimates of key ACEs indicators for your area by visiting the CAHMI site at www.childhealthdata.org.
