Favorite Quote: "If one hundred people all drink from the same well and ninety-eight of them develop diarrhea, I can write prescription after prescription for antibiotics, or I can stop and ask, 'What the hell is in this well?'" (12).
My Impressions: I've gotten into reading a lot of psychology books the past few years, and this is one of my favorites. While many of the books I review are written from a Christian worldview, this one is not religiously affiliated; however, it is a fantastic read. If you've never heard of the Adverse Childhood Experiences (ACEs) assessment, I hope you will take some time and do some research on it. This book essentially encapsulates the journey of one doctor to figure out what was at the bottom of the "well" in low-income communities where improved healthcare measures didn't seem to be improving health outcomes. Dr. Nadine Burke Harris, whom you may know as the Surgeon General of California, writes a compelling book about her efforts to help children and families in low-income communities, and what she learned in the process:
Twenty years of medical research has shown that childhood adversity literally gets under our skin, changing people in ways that can endure in their bodies for decades. It can tip a child's developmental trajectory and affect physiology. It can trigger chronic inflammation and hormonal changes that can last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase the risk for heart disease, stroke, cancer, diabetes—even Alzheimer's (xv).
I had heard about ACEs before, and had even looked over the assessment, but I didn't know any of the history or work or research that had been done surrounding the assessment until this book. As she acknowledges in the book, the term was not coined by her, but was originally part of a 1998 article in the American Journal of Preventative Medicine called, "Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: the Adverse Childhood Experiences (ACE) Study" by Dr. Vincent Felitti, Dr. Robert Anda, and colleagues. Dr. Felitti was actually working in a Kaiser obesity clinic when he discovered that an unusually high number of his patients had suffered sexual abuse as children. Between 1995 and 1997, Felitti and Anda conducted a study in which a questionnaire was sent to over 17,000 members of the Kaiser healthcare system, which consisted of 10 questions about negative childhood experiences. Every question answered "yes" is considered a point, with 10 points being the maximum score. The correlations they found between those with higher scores and those with critical health conditions were staggering, to say the least. Overall, the higher a person's ACE score, the greater the risk to his or her health. Harris notes, "For instance, a person with four or more ACEs was twice as likely to develop heart disease and cancer and three and a half times as likely to develop chronic obstructive pulmonary disease (COPD) as a person with zero ACEs" (38).
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