Understanding Childhood Trauma and What We Can Do About It

UNDERSTANDING CHILDHOOD TRAUMA AND WHAT WE CAN DO ABOUT IT

Flojaune Griffin Cofer, PhD, MPH Director of State Policy & Research Public Health Advocates ANAKIN SKYWALKER AKA DARTH VADER Adolescence/YA: Anakin’s age:

• Trusted adult Episode 1: 9 years old Health Excellent relationship Episode 2 : 19 years old with Obi-Wan Episode 3: 22 years old Kenobi Episode 4: 41 years old • Jedi Education Adulthood: Episode 5: 44 years old • Freed from • Unplanned multip Episode 6: 45 years old slavery pregnancy (Luke & Leia) Childhood : • Lacks Trust • Child Slave • Corrupting influences

Protective Factors Protective • Taken from his (Sith Lord Darth Risk Factors Risk mother to be Sidious) trained as a Jedi Adolescence/YA: • Domestic Violence in at age 10 • Exposure to Marriage to Padme Conception & • Abandonment violence via • Severely burned Pregnancy: • Heightened Clone Wars • Death Star Explosion

• Born a slave arousal • Mom dies • Ongoing war Health Poor Poor • Absent Father • Fear of Loss • Premature death

Conception Demise

©Flojaune Griffin, 2014 Adverse CHILDHOOD Experiences (ACEs)

ADVERSE COMMUNITY EXPERIENCES

• DIRECT: Witness or experience racism and violence • COMMUNITY: Feel and experience racism and violence everywhere • Prevents us from meeting our basic need: Safety • High levels of trauma across the population Historically Advantaged and Disadvantaged A Group Analysis for the United States

TYPE OF OPPRESSION VARIABLE ONE-UP ONE-DOWN Racism Race/Ethnicity/Color White People of Color (African, Latinx, Native, Asian/PI,) Sexism Gender Men Women, non-binary, transgender Heterosexism Sexual Orientation Heterosexual LGBTQIA

Religious Oppression Religion Protestants Sikhs, Muslims, Jews, Catholics*, Not religious Classism Socioeconomic Class Owning, upper/middle Poverty, working class, low hourly wage class, managerial workers Elitism Education level/ College-educated; Not college-educated; less prestigious schools place in hierarchy top 20-40 schools Xenophobia Immigration Status U.S. Born Immigrants (especially from nonwhite countries) Linguistic Oppression Language English Speakers Non-English Speakers Ableism Physical or mental Able-bodied persons People with disabilities ability (body/mind) COMMUNITY TRAUMA

• Social order shapes how we interact within our cultural context • Unwritten rules • Institutions reinforce and politically define power dynamics • Written rules • Racism is a power dynamic of economic and social value What is racism?

• Personally mediated racism - an acute stressor, including individual insults and discriminatory acts • Institutionalized racism - discriminatory, race- or class-based policies and practices (informal and formal) • Cultural racism - determines which group qualities and characteristics are valued/devalued • Internalized racism - acceptance by members of the stigmatized races of negative messages about their own abilities and intrinsic worth

(adapted from CP Jones AJE 2001;154;299-304) and Project Change 1999 REDLINING: An Example of Institutional Racism

• Official Practice 1934-1968 • Grades that FHA gave to neighborhoods • Green (A) - “best” • Blue (B) - “still desirable” • Yellow (C) - “definitely declining” • Red (D) for “hazardous” Fifty Years Later in 2018… • 2/3 of D areas are inhabited by mostly Black and Latinos • 91% of A areas remain middle-to- upper-income today • 85% still predominantly white Science of StressSCIENCE OF STRESS STRESSORS

Hypothalamus Corticotropin-Releasing Hormone (CRH) Pituitary Gland Adrenocorticotropic Hormone (ACTH) Adrenal Glands

CORTISOL

Cardiovascular and Immune

Image adapted and used with permission from GB HealthWatch Systems TOXIC STRESS Health pathways are affected by toxic stress, especially during critical or sensitive periods How Toxic Stress Impacts the Brain

• Impacts brain development and regulation: • Memory and concentration • Sleep disturbances • Hypervigilance • Self-Control • Sense of self and attachments • Risk-Taking to Re-establish control Sources of Trauma INTERGENERATIONAL TRANSFER

• People within a family often share • Genetics • Environment • Behaviors • Intergenerational Trauma • Epigenetic transfer • Decreased DNA Methylation (gene silencing) of Glucocorticoid Receptors in hippocampus increases uptake of cortisol deregulates stress response • Children raised by an adult with 1 or more ACEs are 1000x more likely to suffer their own ACEs ANAKIN SKYWALKER AKA DARTH VADER

Adolescence: Anakin’s age:

• Trusted adult Episode 1: 9 years old Health Excellent relationship Episode 2 : 19 years old with Obi-Wan Episode 3: 22 years old Kenobi Episode 4: 41 years old ACE Score: 6 • Jedi Education Adulthood: Episode 5: 44 years old • Freed from • Unplanned multip Episode 6: 45 years old slavery pregnancy (Luke & Leia) Childhood : • Lacks Trust • Child Slave • Corrupting influences

Protective Factors Protective • Taken from his (Sith Lord Darth Risk Factors Risk mother to be Sidious) trained as a Jedi Adolescence: • Domestic Violence in at age 10 • Exposure to Marriage to Padme Conception & • Abandonment violence via • Severely burned Pregnancy: • Heightened Clone Wars • Death Star Explosion

• Born a slave arousal • Taken from his • Ongoing war Health Poor Poor • Absent Father • Fear of Loss family • Premature death

Conception Demise ACE Score: 5

• Emotional safety must be considered in policy priorities similar to other basic needs • Risk factor for behavioral, physical and mental health outcomes • Change the frame from What’s WRONG with you? to What HAPPENED to you? Public Health Advocates

• Founded in 1999 – California Center for Public Health Advocacy 55% • Statewide – Los Angeles, Stockton, Sacramento, HEAL Cities • Data driven System, Policy and Environmental (SPE) change • Chronic Disease Focus • Nutrition, Water, Sugary Drinks, Built Environment • Diabetes Prevention • Trauma as SPE opportunity Current work includes: • School Trainings: Reduce school suspensions and Expulsions • Built Environment Contact Information

Flojaune G. Cofer, PhD, MPH Director of State Policy and Research [email protected] 844-962-5900 x 230 http://phadvocates.org Twitter: @WearePHA @Flojaune