Perspectives (August 2016)
Sara Merz, Director, AHA
I was just at the National Association of Counties annual meeting with Wake County colleagues, former Minnesota colleagues, and other county leaders from across the nation.
One of the most compelling new things I learned about health is a risk index measuring “Adverse Childhood Experiences” or ACE.
This is a predictor of health and life expectancy. The good news is that there are things people and their health care providers can do to build resilience and improve health outcomes–like physical activity, healthy eating, sleep patterns, mindfulness and therapy. For young children at risk of these adverse experiences, home visits and strong parental buffering or presence of one caring adult can also increase resilience and lower health risks.
Here’s the back story and the health effects. About 10 years ago, a doctor noticed that half of his patients regained weight they had lost. After asking more questions, he learned they all had experienced childhood abuse. This led to creation of an assessment tool listing 10 adverse childhood experiences like physical abuse, a parent with alcohol or chemical dependency and more.
Patient surveys that showed the more of these adverse experiences they faced, the higher their health risks were. Patients with 3 of 10 experiences were three times as likely to have heart disease or depression. Those who experience 6 out of 10, die 20 years younger without intervention to increase resilience. ACE turns out to be a better predictor than factors we commonly think of. The film Resilience tells the story.
Some counties in Washington have been doing long-term work using these strategies and found they had decreased incarceration, decreased suicide by 65%, decreased domestic abuse by 35% and decreased youth arrests by more than 50%. They measured a $1.4 billion savings over a 10-year period.
These findings in effective resilience techniques can have a major impact on health, quality of life, well-being, and health care costs for the entire population as well as for those who experience greatest disparities.
This fits with the Live Well San Diego initiative (which AHA partners and community leaders heard about in April) that features a 3-pronged approach to healthy communities: Building Better Health, Living Safely, and Thriving. For a healthy Wake County, we need to come from multiple directions working together. Under the AHA Board of Director’s leadership, we continue to have discussions about moving in this direction here in Wake. More to come!