If we consider why certain groups are at increased risk for diabetes, heart attack, stroke, cancers and other health issues, we can look back in time to their childhood for answers.

Children who experience more Adverse Childhood Experiences, also referred to as ACEs, are more likely to suffer with chronic health issues as adults.

Research has show that adverse childhood experiences (ACE) do not affect all children equally.

In the United States, those from marginalized identities are much more likely to have experienced early childhood trauma, which can have lasting effects on one’s health.

The more adverse experiences that happen before the age of 18, the more likely adults are likely to express a wide array of chronic health problems including: diabetes, overweight, cancers, hypertension, stroke, heart attack, mental health issues, substance use, and more.

ACEs are a societal issue.

Due to the complex intersections identity, socioeconomic status, and healthcare access, marginalized individuals are much more impacted by ACE.

This puts certain individuals at higher risk of future chronic conditions in adulthood, like diabetes. These inequities are a by-product of social determinants of health and the impact on individuals and communities. As diabetes advocates, we are compelled to reflect on these intersections to improve health outcomes.

The World Health Organization describes the social determinants of health as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.”

We need to explore and address the social determinants of health to fight for health equity for all people.

This unfair distribution of access and services results in the unfair but avoidable differences in health status seen between different neighborhoods, zip codes, and even states.

Health Equity Defined

Strategies to Improve Health by Strengthening Communities

Achieving equity will take time and is complicated by a long history of institutionalized racism, sexism, and other prejudices. We need to make legislative adjustments that compel corporations, educational systems, health care agencies, and local governments to assure equitable access to services to those who have been historically excluded.

Start with our children. If societies are structured to help children feel safe and protected, they will enter adulthood healthier and more prepared to perpetuate health for future generations. I highly recommend all those involved in diabetes education listen to this groundbreaking video which explores the science between childhood trauma and health: Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health.

ACE-Aware Training Program: The other obvious place to direct our energy is with our adult clients who are living with prediabetes or diabetes. We know that many of them may be having difficulty making behavior changes and engaging with their health care due to adversity experienced in childhood. Let’s set up or health care facilities to provide Trauma-Informed Care. If you would like to learn more about this topic, I encourage you to get started in this free training worth 2.0 CEs. Becoming ACE-Aware Training Program. I completed this program a few months ago and found it compelling and instructive.

A Practitioner’s Guide to Advancing Health Equity CDC PDF

• The Practitioner’s Guide to Advancing Health Equity can help public health practitioners reduce disparities in chronic diseases. It provides a collection of health equity considerations for policy, systems, and environmental improvement strategies focused on tobacco-free living, healthy food and beverages, and active living.

Thank you for reading this post and we invite you to send us comments or additional resources to [email protected]. We read each email and appreciate your contributions.

Equity and Trauma-Informed Care Resources

COVID-19 & Diabetes: Examining the impact of health disparities in a time of crisis(link is external) – This live event, posted on the ADA website, was recorded Thursday, April 23. It provides an excellent exploration of health equality vs. health equity with honest and insightful discussions by a panel of experts. As the nation grapples with the COVID 19 health crisis, communities already experiencing social, economic, and health disparities face even more severe challenges combatting this disease. Join us for an information-packed webinar exploring the nexus of COVID-19, diabetes, and health equity.

Daniel E. Dawes, JD, Author, The Political Determinants of Health, and Director, Satcher Health Leadership Institute at Morehouse School of Medicine. 

Adverse Childhood Experiences (ACE) Resources

Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health

Becoming ACE-Aware Training Program

ACE Screening Tool and Resilience Inventory

Posted on www.AcesAware.org A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences

Dr. Dayna Long, Director for the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland, discusses the pervasiveness of Adverse Childhood Experiences (ACEs) and why screening for ACEs is critical to providing trauma-informed care.

NPR Article – Take the ACE Score and Learn what it does and doesn’t mean

Trauma-Informed Care Fact Sheet

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