Throughout history, the practice of medicine has always been one of “sick visits,” where one sought treatment only when acutely ill, typically with an issue related to an infectious disease. With the advent of antibiotics in the mid 20thcentury, improved pharmacotherapy affecting other acute illnesses, and improved surgical techniques, many of these acute diseases were either cured or rendered almost nonexistent with treatment. With the decreased morbidity and mortality caused by these treatable illnesses, the concept of long-term, chronic disease has become the prevailing issue affecting people in the United States.
Beginning in the late 1990s, researchers started to link the concept of uncontrolled, toxic stress during childhood caused by Adverse Childhood Experiences (ACEs) to poor health and social outcomes in later childhood and as adults. This revolutionary thought—linking adult health and wellness to childhood events—has given rise to the next great public health opportunity in the US: if ACEs can be reduced in early childhood, the overall health of the US population will significantly improve in the next generation. New research has shown that small decreases in a population’s toxic stress during childhood has a relatively large decrease in the risk of adult disease—both mental and physical—as well as major decreases in the costs incurred by caring for chronically sick adults. In addition, researchers are starting to elucidate the mechanisms of how toxic stress in a child can have permanent effects on a person’s health through the biochemical mechanisms associated with epigenetics. In fact, epigenetics also seems to explain how toxic stress can be passed from parent to child in utero, where stress in a mother or father can alter the long-term stress responses and health outcomes of their offspring. Thus, there is now a molecular biology explanation for the concept of multigenerational trauma.
With this strong background based in science, it is now possible to design and build evidence-based programs that will improve the ability of families to raise healthy children in a loving and supportive environment. To be maximally effective, these programs will have to span all of the environments in which families live—from communities, to workplaces, to schools, and to healthcare clinics and hospitals. In addition, families need to be effectively screened to identify those in need and the specific issues where programs can be most helpful.
This talk will touch on all of these topics, and it will give the audience the knowledge needed to be effective advocates to support the next generation of Alaskans to reach their best potential.