Building Resilience Against the Sequelae of Adverse Childhood Experiences: Rise Up, Change Your Life, and Reform Health Care

Abstract

A reformed approach to health care tackles health at its roots. Adverse childhood experiences (ACEs) in those exposed to them may contribute significantly to the root causes of many diseases of lifestyle. ACEs are traumatic experiences, such as physical and emotional abuse and exposure to risky family environments. In 1998, a ground-breaking study found that nearly 70% of Americans experience at least 1 ACE in their lifetime, and graded exposure is associated with the presence of mental health disorders, heart disease, cancer, and other chronic diseases. Over the past 20 years, evidence has demonstrated further disease risk, outcomes, and epigenetic underpinnings in children and adults with ACEs. Building resilience—the capacity to adapt in healthy ways to traumatic experiences—through lifestyle modification offers potential to combat the negative health effects associated with ACEs. Emerging research demonstrates resilience is cultivated through individual skills (emotional intelligence, coping, and fostering healthy lifestyle choices), and nurturing supportive relationships. Being mindful of the impact and prevalence of ACEs and diversity of individuals’ experiences in society will help build resilience and combat the root cause of chronic disease. This review aims to cultivate that awareness and will discuss 3 objectives: to discuss the effects and hypothesized pathophysiological underpinnings of traumatic experiences in childhood on health and wellbeing throughout life, to present ways we can promote resilience in our daily lives and patient encounters, and to demonstrate how advocacy for the reduction of ACEs and promotion of resilient, trauma-informed environments are fundamental to health care reform.

Childhood adversity and mental health among Chinese young adults: The protective role of resilience

“…One reason why some people exposed to ACEs do not develop poor mental health is because they have had the support of at least one safe, stable and nurturing adult caregiver relationship (Centers for Disease Control and Prevention [CDC], 2019). These positive relationships foster resilience by buffering the negative effects of ACEs (Fritz et al, 2018;Ortiz, 2019;Traub & Boynton-Jarrett, 2017). Recent evidence has shown that resilience can attenuate the impact of ACEs on mental health outcomes, including depression (Poole et al, 2017;Wingo et al, 2010), substance abuse (Wingo et al, 2014) and schizophrenia (Lee et al, 2018).…”

Lifestyle Medicine 2019: Deeper, Broader, and More Precise

“…The article by Ortiz 6 offers a fresh perspective that may not be familiar to many lifestyle medicine practitioners concerning the potential negative sequelae arising from ACEs. ACEs contribute to many of the root causes of chronic disease related to lifestyle.…”

“…ACEs are extremely common among Americans, with the shocking finding that nearly 70% of Americans experience at least 1 ACE in their lifetime, and such exposures may be associated with the presence of multiple adverse sequelae, including mental health disorders, heart disease, cancer, and other chronic diseases. Ortiz 6 lays out a compelling approach for lifestyle medicine practitioners to combat the sequelae of ACEs and help both children and adults build higher levels of resilience.…”

Translation of Lifestyle Into Clinical Practice: Making the Case, Providing the Cure

“…Tackling the effects of ACEs requires resiliency strategies (mindfulness and social-emotional learning), trauma-informed care, and policy/advocacy in communities. 13 A grassroots approach to changing the culture of medicine within medical education is discussed in an article by Dr Melissa Mondala and myself. We present a review of the contributions in the literature and contributions of Lifestyle Medicine Interest Groups (LMIGs) and professionals in training to ACLM.…”

“…Tackling the effects of ACEs requires resiliency strategies (mindfulness and social-emotional learning), trauma-informed care, and policy/advocacy in communities. 13…”