Advocacy and Action in Appalachia Aimed at Adverse Childhood Experiences

Abstract

Rural Appalachia faces extreme poverty-linked hardships, often referred to as ‘social determinants of health'. One social determinant of health often linked with rural poverty is adverse childhood experiences (ACEs). ACEs refer to numerous experiences (e.g., forms of abuse and maltreatment, a dysfunctional household, mental illness in the household, etc.) that one encounters before the age of 18. Local leaders of a county in the heart of Appalachia in northwestern North Carolina (Watauga) embarked on a community level initiative (Watauga Compassionate Community Initiative) aimed at preventing and treating the effects of ACEs and building resiliency. This chapter delves into the academic research related to ACEs and poverty and details the background and ongoing story of the Watauga Compassionate Community Initiative, concluding with lessons learned and insights into what other rural communities can focus on when addressing ACEs, poverty, and other social determinants of health.

Adverse Childhood Experiences and Cardiovascular Disease Risks: Implications for North Carolina and the Need for an Upstream Approach

“…AppHealthCare also focuses on addressing root causes (i.e., poverty, housing, economic mobility and opportunity, social capital) at the policy and systems levels. School leaders in Watauga County have adopted a Compassionate Schools approach, and multiple stakeholder agencies have partnered to form the Watauga Compassionate Community Initiative (WCCI) [34][35]. This group includes school officials, public health and social service agencies, political leaders and government officials, early childhood and other nonprofit agencies, and medical professionals working together to advocate for the community and to inform policies and practices (universal home visitation, family-friendly work policies, housing, etc.)…”