Background
Physical and sexual childhood abuse is associated with poor health across the lifespan. However, the association between these types of abuse and actual health care use and costs over the long run has not been documented.
Objective
To examine long-term health care utilization and costs associated with physical, sexual, or both physical and sexual childhood abuse.
Introduction Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults.
Methods We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate.
The University of Florida’s Dr. Nancy Hardt has an unusual double specialty: She’s both a pathologist and an OB-GYN. For the first half of her career, she brought babies into the world. Then she switched — to doing autopsies on people after they die.
“I want to prevent what I’m seeing on the autopsy table. … A lot of times, I’m standing there going, ‘I don’t think this person had a very nice early childhood.’ ”
Dr. Nancy Hardt, pathologist, University of Florida
It makes perfect sense to her.
“Birth, and death. It’s the life course,” Hardt explains.
A few years ago, Hardt says, she learned about some research that changed her view of how exactly that life course — health or illness — unfolds.
Dear Doctor: What you didn’t ask, and what I didn’t tell you
I am your patient. We have known one another for a long time, and I want to thank you for healing me so many times.
At present, you know me only from annual checkups as a healthy 58-year-old, divorced, Caucasian female; 120 lbs, 5’6″; two adult children; parents and all four siblings living; family history of diabetes, epilepsy, alcoholism, bowel cancer, and heart disease; no medications.
You met me first in 1943 in Pennsylvania. I was a normal 5 lb 6 oz infant, born under general anesthesia. My mother nursed me for eight months, and I grew normally. You were surprised and concerned when I returned in six weeks for a well-baby check and immunizations. I had developed an extremely loud heart murmur, but you assured my worried mother no surgery was needed.
The Alternative Schools Network (ASN) Youth Resilience Project is an initiative that grew from the collective desire to develop and provide additional clinical resources for nonprofit and alternative schools in the ASN Network. The Youth Resilience Project is dedicated to the cause of bringing knowledge, awareness, and support to schools around issues associated with youth trauma.
Spreading the knowledge of trauma and its impacts on youth development became a mission of ASN’s Clinical Team after witnessing firsthand how it could help improve relationships, interventions, and overall programming among some of the hardest to reach youth in the alternative schools.
For the past five years, the Hayward Unified School District has been focusing on its lowest-income neighborhoods, transitioning to a “community schools” approach that provides health, social and other services to students and their families.
The East Bay Area district south of Oakland offers a case study in the potential of an approach whose goal is to transform schools into hubs for the entire community by offering a range of services, such as mental health counseling, health clinics, after-school programs and classes for parents.
Let me tell you, dinner with a behaviorist is an experience, a somatic experience. Lily (name changed to protect her 😉 ) and I shared Indian food two nights ago in Keene, NH.
As I shuffled into the restaurant ten minutes late (typical me), I rounded the corner and saw her sitting at a table for two. I beamed; I knew I was in for some rich discussion and a total “nerding out” session.
Lily and I are former colleagues. We worked together for only a year, but it was my first year in a new school. Lily was there — someone safe whom I could confide in. She is a school psychologist by training, but a self-proclaimed hard core “behaviorist.” She even holds that title in her current job.
When urban teens were asked to identify solutions for reducing violence in their New Haven, Connecticut community, their recommendations were loud and clear: They hoped for better employment opportunities, more after-school activities, and a cleaner city environment.
The teens’ suggestions are the culmination of a unique project called Youth Haven in which 12 youth ambassadors between the ages of 16 and 18 were recruited from city public schools for their interest in violence prevention.
As part of the project, the teens held a citywide Youth Congress in an effort to hear and discuss other teens’ ideas on how to reduce community violence. Each group was led by a youth ambassador and facilitated by adult academic and community partners. Among teens attending the conference, 61 percent reported having a family member who had been killed by an act of violence, and 81 percent said a family member had been hurt by an act of violence.
Secure, trusting bonds are essential if young people are to grow, learn, and thrive (Baumeister, 2011; Brendtro, Brokenleg, & Van Bockern, 2005; Shulevitz, 2013).
Today there are literally millions of young people disconnected and living in violent communities with over stressed families and schools that are depersonalized. They traverse dangerous communities and the ecology in which they live is one of extreme levels of toxic stress.
The most troubled and troubling kids display behaviors that increase their disconnection and also increase their alienation from caring adults. These kids get kicked out of everything and often as they get into high school are expelled to nowhere.
Youth at risk experience pervasive emotional pain and react with pain-based behavior (Anglin, 2014).
We all know that when children aren’t well, they’re less likely to learn.
More and more teachers recognize that children who can’t sit still in class, act out, or have asthma may be showing warning signs of a toxic exposure to childhood trauma.
More than two decades ago, landmark research from the Centers for Disease Control and Prevention and Kaiser Permanente found that exposure to adverse childhood experiences, or ACEs—ranging from parental addiction to abuse, neglect, or divorce—can have lasting effects on children’s health. These ACEs can lead to abnormal levels of stress hormones—a condition known by doctors as toxic stress, which increases kids’ risk of serious illnesses including asthma and diabetes, as well as long-term problems including heart disease and cancer later in life.