Recent research has increased attention on the wide-ranging and serious consequences of adverse childhood experiences (ACEs). Over 45% of children in the United States – 33.3 million children – have experienced potentially traumatic events that impede their chances to be healthy, productive adults. ACEs can range from neglect or abuse to substance misuse by a parent, and they are a shared root cause of many of society’s most challenging problems. Elementary school success and school success rates, juvenile incarceration, challenges in the workplace, and numerous physical and mental health challenges are all associated with ACEs. Foundations focused on issues such as education, economic opportunity, youth development, health, or community revitalization are beginning to recognize that ACEs are at the root of many of societies’ challenges. As pediatrician and child advocate Nadine Burke Harris said in her book The Deepest Well: Healing the Long-term Effects of Childhood Adversity:
“When we understand that the source of so many of our society’s problems is exposure to childhood adversity, the solutions are as simple as reducing the dose of adversity for kids and enhancing the ability of caregivers to be buffers…The cause of harm [childhood adversity] does not need to be totally eradicated. The revolution is in the creative application of knowledge to mitigate harm wherever it pops up.”
It’s important to understand why ACEs have such a powerful influence. Scientific evidence has established that children’s early experiences impact their brain development. Positive experiences in safe environments promote strong foundations for a child’s developing brain. However, adverse experiences without appropriate support and buffers from caregivers can lead to toxic stress, a dysregulation of the body’s natural stress response, which negatively impacts the developing brain and body. Toxic stress is a departure from the normal, everyday stress that is natural for development, such as the stress of a test in school or nerves before a swim meet or soccer game. Rather, toxic stress leads to elevated levels of stress hormones that alter the architecture of the brain.
Adverse childhood experiences and the resulting toxic stress are associated with serious physical, cognitive, social, and emotional consequences throughout the lifespan. For instance, babies and children may face more growth delays, cognitive delays, sleep disruption, higher rates of asthma, infections, and learning and behavioral difficulties. Adolescents may experience higher rates of obesity, smoking and violence, and lower educational outcomes. Moreover, among adults, the presence of four or more ACEs nearly doubles the risk for 5 of the 12 leading causes of mortality in the United States. Without the appropriate support, ACEs can impact performance in school and the workplace across the course of one’s life.
Many racial disparities in long term health outcomes, education outcomes, and incarceration rates start with disparate exposure to and protection from childhood trauma. Black and Latinx children face increased risk of ACEs: 61% of black non-Hispanic children and 51% of Hispanic children have an ACE, compared with 40% of white non-Hispanic and 23% of Asian non-Hispanic children. And, research shows that children of color are treated differently than white children when they exhibit the same trauma-related behaviors in the classroom (e.g., expelling children from early learning settings rather than inquiring about context and addressing a root issue). Foundations committed to closing opportunity gaps and advancing equity should pay particular attention to the impacts of childhood trauma.
Given the widespread prevalence of ACEs and their impact on a host of life outcomes, the philanthropic community should prioritize supporting families, communities, and state and local governments with ACEs prevention and mitigation. Here are 5 considerations for foundations interested in becoming more involved in ACEs based on our conversations with and observations of corporate and private foundations across the US:
- Foundations can help to bridge the gap from knowledge to practice. There is significant knowledge about the effects that trauma has on the brain and children’s long-term health, economic and social outcomes, but less on how to change practice based on trauma-informed principles. In order to reduce the burden of trauma, family-serving professionals—including teachers, child care providers, health care providers, public sector employees who distribute WIC, SNAP and other benefits, and judges and attorneys in family and juvenile court—must understand the effects of childhood trauma and change their practices based on a deep understanding of the effects of trauma on children and their families. Philanthropy can help to spread understanding of the science about ACEs and to identify and spread successful practice change. For instance, foundations’ high-risk capital can fill a missing gap; funding evaluation pilots of practice changes to form a proof of concept for how professionals can change their work. Moreover, foundations are in a unique position to convene various grantees to share learning, research, and data about trauma-informed and healing-centered practices. Because of their vast networks, foundations can also convene and support learning communities of professionals across a state or region within and across disciplines.
- Foundations can facilitate collaboration across disciplines. Preventing and mitigating the effects of adverse childhood experiences requires action from individuals across disciplines such as health, education, juvenile justice, and child welfare. Given the silos between these fields, foundations can play a role in developing inclusive processes to help build a common understanding of potential interventions for ACEs. Foundations can play an important role in bolstering cross-sector coordination and collaboration to address ACEs in a city or state. For example, in New Jersey, FSG conducted a state level landscape assessment for The Burke Foundation, The Nicholson Foundation, and the Turrell Fund on opportunities to address ACEs. Results of this assessment were shared with leaders in health, social welfare, education, law enforcement, and other sectors in a statewide symposium on ACEs hosted by the three foundations. At the event, significant cross-sector connections formed. For instance, a police chief connected with a school administrator to talk about a program called Handle with Care, which provides for communication between the police department and a child’s school if a child may have experienced a traumatic event involving police.
- Foundations can adopt principles and practices to become trauma-informed organizations themselves. Foundations can consider how their internal practices support their external work in trauma. The trauma-informed philanthropy guide released by The Thomas Scattergood Behavioral Health Foundation, the United Way of Greater Philadelphia and Southern New Jersey (UWGPSNJ), and Philanthropy Network Greater Philadelphia provides suggested principles of trauma-informed practice for foundations. Their recommendations include promoting leadership and inclusion of marginalized groups, ensuring that consumers (e.g., parents, youth), community organizations, and service providers all “have a voice in determining community needs, priorities, and strategies of change increase the potential for impact,” and acknowledging and addressing power structures. If foundations change the way they work to be more trauma-informed or healing-centered, it will impact both their partners in the field and their staff.
- Foundations working on ACEs should build on and support existing work, rather than attempt to own the solutions themselves. Efforts to promote awareness of ACEs, spread trauma-informed training and technical assistance, and change programs, policies, and practices should build upon the excellent existing efforts, including many that have been working for decades on child wellbeing, whether or not they have used the term “ACEs”. As the health sector is showing increased energy around this topic, they should build on the expertise of early childhood educators, social workers, and mental health providers who have focused on trauma for a long time. Foundations can play a role in connecting the dots between various efforts to support child wellbeing, even if the stakeholders are using different terminology.
- Foundations seeking to engage in this work should address the effects of past and current policies and structures that create unequal opportunities for families, especially families of color and low-income families. These structural inequities lead to the conditions in which marginalized families face increased risk of adverse childhood experiences in the first place. Foundations should analyze and address power dynamics at various levels of the work—whether within a local coalition or between a foundation and a grantee—and acknowledge the roles that race, racism, and structural inequity play in childhood trauma in order to be most effective in designing new programs and policies. Additionally, foundations should seek to elevate the voices of children, families, and communities, particularly those who have experienced ACEs, to ensure that solutions are generated by and sustainable for communities.
Increased support from philanthropy can help address what is arguably one of the largest public health issues of our time. If you have other ideas on how foundations can best contribute to mitigating the impacts of child trauma, please contact us.
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