How childhood trauma affects health across a lifetime | Nadine Burke Harris

In the mid-’90s, the CDC and Kaiser Permanente discovered an exposure
that dramatically increased the risk for seven out of 10 of the leading
causes of death in the United States. In high doses, it affects
brain development, the immune system, hormonal systems, and even the way our DNA
is read and transcribed. Folks who are exposed in very high doses have triple the lifetime risk
of heart disease and lung cancer and a 20-year difference
in life expectancy. And yet, doctors today are not trained
in routine screening or treatment. Now, the exposure I’m talking about is
not a pesticide or a packaging chemical. It’s childhood trauma. Okay. What kind of trauma
am I talking about here? I’m not talking about failing a test
or losing a basketball game. I am talking about threats
that are so severe or pervasive that they literally get under our skin
and change our physiology: things like abuse or neglect, or growing up with a parent
who struggles with mental illness or substance dependence. Now, for a long time, I viewed these things in the way
I was trained to view them, either as a social problem —
refer to social services — or as a mental health problem —
refer to mental health services. And then something happened
to make me rethink my entire approach. When I finished my residency, I wanted to go someplace
where I felt really needed, someplace where I could make a difference. So I came to work for
California Pacific Medical Center, one of the best private hospitals
in Northern California, and together, we opened a clinic
in Bayview-Hunters Point, one of the poorest, most underserved
neighborhoods in San Francisco. Now, prior to that point, there had been only
one pediatrician in all of Bayview to serve more than 10,000 children, so we hung a shingle, and we were able
to provide top-quality care regardless of ability to pay. It was so cool. We targeted
the typical health disparities: access to care, immunization rates,
asthma hospitalization rates, and we hit all of our numbers. We felt very proud of ourselves. But then I started noticing
a disturbing trend. A lot of kids were being
referred to me for ADHD, or Attention Deficit
Hyperactivity Disorder, but when I actually did
a thorough history and physical, what I found was that
for most of my patients, I couldn’t make a diagnosis of ADHD. Most of the kids I was seeing
had experienced such severe trauma that it felt like something else
was going on. Somehow I was missing something important. Now, before I did my residency,
I did a master’s degree in public health, and one of the things that they teach you
in public health school is that if you’re a doctor and you see 100 kids
that all drink from the same well, and 98 of them develop diarrhea, you can go ahead
and write that prescription for dose after dose
after dose of antibiotics, or you can walk over and say,
“What the hell is in this well?” So I began reading everything that
I could get my hands on about how exposure to adversity affects the developing brains
and bodies of children. And then one day,
my colleague walked into my office, and he said, “Dr. Burke,
have you seen this?” In his hand was a copy
of a research study called the Adverse Childhood
Experiences Study. That day changed my clinical practice
and ultimately my career. The Adverse Childhood Experiences Study is something that everybody
needs to know about. It was done by Dr. Vince Felitti at Kaiser
and Dr. Bob Anda at the CDC, and together, they asked 17,500 adults
about their history of exposure to what they called “adverse
childhood experiences,” or ACEs. Those include physical, emotional,
or sexual abuse; physical or emotional neglect; parental mental illness,
substance dependence, incarceration; parental separation or divorce; or domestic violence. For every yes, you would get
a point on your ACE score. And then what they did was they correlated these ACE scores
against health outcomes. What they found was striking. Two things: Number one, ACEs are incredibly common. Sixty-seven percent of the population
had at least one ACE, and 12.6 percent, one in eight,
had four or more ACEs. The second thing that they found was that there was
a dose-response relationship between ACEs and health outcomes: the higher your ACE score,
the worse your health outcomes. For a person with an ACE score
of four or more, their relative risk of chronic
obstructive pulmonary disease was two and a half times that
of someone with an ACE score of zero. For hepatitis, it was also
two and a half times. For depression, it was
four and a half times. For suicidality, it was 12 times. A person with an ACE score
of seven or more had triple the lifetime risk
of lung cancer and three and a half times the risk
of ischemic heart disease, the number one killer
in the United States of America. Well, of course this makes sense. Some people looked at this data
and they said, “Come on. You have a rough childhood,
you’re more likely to drink and smoke and do all these things
that are going to ruin your health. This isn’t science.
This is just bad behavior.” It turns out this is exactly
where the science comes in. We now understand
better than we ever have before how exposure to early adversity affects the developing brains
and bodies of children. It affects areas like
the nucleus accumbens, the pleasure and reward
center of the brain that is implicated
in substance dependence. It inhibits the prefrontal cortex, which is necessary for impulse control
and executive function, a critical area for learning. And on MRI scans, we see measurable differences
in the amygdala, the brain’s fear response center. So there are real neurologic reasons why folks exposed
to high doses of adversity are more likely to engage
in high-risk behavior, and that’s important to know. But it turns out that even if you don’t
engage in any high-risk behavior, you’re still more likely
to develop heart disease or cancer. The reason for this has to do with
the hypothalamic–pituitary–adrenal axis, the brain’s and body’s
stress response system that governs our fight-or-flight response. How does it work? Well, imagine you’re walking
in the forest and you see a bear. Immediately, your hypothalamus
sends a signal to your pituitary, which sends a signal
to your adrenal gland that says, “Release stress hormones!
Adrenaline! Cortisol!” And so your heart starts to pound, Your pupils dilate, your airways open up, and you are ready to either
fight that bear or run from the bear. And that is wonderful if you’re in a forest
and there’s a bear. (Laughter) But the problem is what happens
when the bear comes home every night, and this system is activated
over and over and over again, and it goes from being
adaptive, or life-saving, to maladaptive, or health-damaging. Children are especially sensitive
to this repeated stress activation, because their brains and bodies
are just developing. High doses of adversity not only affect
brain structure and function, they affect the developing immune system, developing hormonal systems, and even the way our DNA
is read and transcribed. So for me, this information
threw my old training out the window, because when we understand
the mechanism of a disease, when we know not only
which pathways are disrupted, but how, then as doctors, it is our job
to use this science for prevention and treatment. That’s what we do. So in San Francisco, we created
the Center for Youth Wellness to prevent, screen and heal the impacts
of ACEs and toxic stress. We started simply with routine screening
of every one of our kids at their regular physical, because I know that if my patient
has an ACE score of 4, she’s two and a half times as likely
to develop hepatitis or COPD, she’s four and half times as likely
to become depressed, and she’s 12 times as likely
to attempt to take her own life as my patient with zero ACEs. I know that when she’s in my exam room. For our patients who do screen positive, we have a multidisciplinary treatment team
that works to reduce the dose of adversity and treat symptoms using best practices,
including home visits, care coordination, mental health care, nutrition, holistic interventions, and yes,
medication when necessary. But we also educate parents
about the impacts of ACEs and toxic stress the same way you would for covering
electrical outlets, or lead poisoning, and we tailor the care
of our asthmatics and our diabetics in a way that recognizes that they may
need more aggressive treatment, given the changes to their hormonal
and immune systems. So the other thing that happens
when you understand this science is that you want to shout it
from the rooftops, because this isn’t just an issue
for kids in Bayview. I figured the minute
that everybody else heard about this, it would be routine screening,
multi-disciplinary treatment teams, and it would be a race to the most
effective clinical treatment protocols. Yeah. That did not happen. And that was a huge learning for me. What I had thought of as simply
best clinical practice I now understand to be a movement. In the words of Dr. Robert Block, the former President
of the American Academy of Pediatrics, “Adverse childhood experiences are the single greatest
unaddressed public health threat facing our nation today.” And for a lot of people,
that’s a terrifying prospect. The scope and scale of the problem
seems so large that it feels overwhelming to think about how we might approach it. But for me, that’s actually
where the hopes lies, because when we have the right framework, when we recognize this to be
a public health crisis, then we can begin to use the right
tool kit to come up with solutions. From tobacco to lead poisoning
to HIV/AIDS, the United States actually has
quite a strong track record with addressing public health problems, but replicating those successes
with ACEs and toxic stress is going to take determination
and commitment, and when I look at what
our nation’s response has been so far, I wonder, why haven’t we taken this more seriously? You know, at first I thought
that we marginalized the issue because it doesn’t apply to us. That’s an issue for those kids
in those neighborhoods. Which is weird, because the data
doesn’t bear that out. The original ACEs study
was done in a population that was 70 percent Caucasian, 70 percent college-educated. But then, the more I talked to folks, I’m beginning to think that maybe
I had it completely backwards. If I were to ask
how many people in this room grew up with a family member
who suffered from mental illness, I bet a few hands would go up. And then if I were to ask how many folks
had a parent who maybe drank too much, or who really believed that
if you spare the rod, you spoil the child, I bet a few more hands would go up. Even in this room, this is an issue
that touches many of us, and I am beginning to believe
that we marginalize the issue because it does apply to us. Maybe it’s easier to see
in other zip codes because we don’t want to look at it. We’d rather be sick. Fortunately, scientific advances
and, frankly, economic realities make that option less viable every day. The science is clear: Early adversity dramatically affects
health across a lifetime. Today, we are beginning to understand
how to interrupt the progression from early adversity
to disease and early death, and 30 years from now, the child who has a high ACE score and whose behavioral symptoms
go unrecognized, whose asthma management
is not connected, and who goes on to develop
high blood pressure and early heart disease or cancer will be just as anomalous
as a six-month mortality from HIV/AIDS. People will look at that situation
and say, “What the heck happened there?” This is treatable. This is beatable. The single most important thing
that we need today is the courage to look
this problem in the face and say, this is real
and this is all of us. I believe that we are the movement. Thank you. (Applause)

About the author


  1. Thank you Nadine. Im going to show my siblings this as we are all adult survivors of childhood abuse and neglect

  2. Well I’m fucked… I scored 7
    Edit: I’m actually scared after watching the full thing. So I’m actually fucked.

  3. Common sense. We can't keep pissing in our own bed sort of speak, without it is going to take a tool on us and our life in one way or the other.

  4. I had ALOT of childhood trauma and it's affected my entire life so negatively!!! I so often want to die!!!

  5. My score is 7. My foster mother tortured and neglected me and I lived in utter terror for years. I'm 49 now and jump at everything, am constantly frightened and on the alert and I get depressed and am obsessed with death. I'd kill myself if I could, but I'm scared in case I mess it up.

  6. I took the ace test, and I have a 7. I have not continued the cycle with my daughter. I know what it feels like, I had abuse on many different levels; physical, mental, emotional from my mother. My dad changed my life, when they divorced he took custody of three preteens and pushed us and encouraged us and we've all turned out pretty well. My dad was military, and he wAs gone a lot, and she hid it well. But he got statements from neighbors, friends, etc for the courts and brought us home. Her mentality is that she doesn't think she was a bad mom, I think that she has a mental disorder, I've seen it more as I got older. I got a BA in Psychology and a BA in Early Childhood Development and have studied almost every different mental disorder, and my mom defiantly has at least two. But I stopped the cycle, I didn't take it and pass that abuse onto my daughter. She knows she's loved, and she knows she can talk to me. She is 11 now and we've moved into serious conversations that I would have never had with my mom. I'm so glad she's confident that she can trust me. And that's what it boils down to, that she trust me and knows I love her more than anything. You can stop the abuse from going on, you can still accomplish things, no matter how much you were put down and told you wouldn't- you can.!

  7. Thank you.
    This was my main focus of study in college. Largely to understand myself. This needs to be more known in order to be addressed. The physical/neurological development is effected. Cortisol effects the development of brain structures.
    Also look at studies by DuBois

  8. I'm a married father of four born and raised in Boston. I was told by my dentist that this city has some of the best medical care in the world. Dispite 51a 's DCF, DSS, it's a terrible feeling when I cannot protect my children from the trauma of emotional abuse. There appears to be no solution. It's like trying to un- ring the bell, or trying to put scrambled eggs back in the shell.

  9. If I spoke loudly, I'd get beaten. I was force bathed by my mother at age 16. Sometimes we'd come back home from family gatherings and she'd beat us, or she'd wait for 2 days and bring up the what happened at that family gathering/what we did and beat my sisters and I. We still live with her as adults for some reason and when my younger cousin comes over, she has this need to beat one of us in front of our cousin.

    And what bothers and hurt me the most, even now, is when she took away my teddy bear and chucked my teddy away simply because she wanted to. She used to flush it in the toilet, throw it in the chute outside and go back down and get it and wash it and give it back to me. And then one day my teddy was permanently gone and as stupid as this sound I cry over it at my full adult age.

  10. Those are beautiful and amazing job mysister why didn't they do this test in the urban communities I wonder how that would turn out if you did this just in the urban communities what would the urban scores be and what are the numbers of those children growing up dying early because of high Ace scores wish they had this when I was a kid maybe I could be kind of safe from the bullshit I'm going through now such as high blood pressure in the stroke and I'm short bought of alcoholism after the military just turned 40 three days ago had a stroke at 34 do the high blood pressure and birth control pills and super amounts of stress + anxiety

  11. Amazing information. Thank you for sharing. I wish more people were aware of this issue, and your screenings would become regular practice.

  12. one day out of the blue, a couple years after high school, I brought nothing with me and left. haven't seen or talked to anybody I knew in 6 years. I think of them from time to time. all is well

  13. Well done experts – you now know what thousands of us fracked up people have known for centuries – Trauma fracks you up.. Seriously, how is it you needed studies to work that one out? DUH

  14. for real though, this made me wanna cry. 7+ ACES here. I have anxiety, c-ptsd, chronic migraines, celiac, ibs, and arthritis in my jaw from grinding. this is too real.

  15. I dont think I've ever seen my father sober. At night I would think he would kill me in my sleep. I barely slept. I'm in my 40s now, super anxious most of the day and it is very hard for me to trust anyone. I was always told not to talk about what goes on in the house. I missed my opportunity to get help.

  16. So what can you do, if anything, once you're an adult and have been through such experiences as a child? Can one reverse it?

  17. A critically important message, brilliantly delivered. This presentation should have many more views but, considering the fact many are in denial about what even constitutes abuse – much less its life-altering effects – I guess it's no surprise. '…maybe we don't want to look at it…' indeed.

  18. My doctor told me last year my pituitary gland wasn’t functioning properly and began to treat me with symplex f along with diet changes…She never mentioned childhood trauma but I had tons of it

  19. How nasty is she, you don't get diagnosed with anything if you've suffered from childhood trauma?…typical academic, part of the problem not the solution!!!

  20. I’m a doctor and I’ve been physically and verbally abused my entire childhood, I also witnessed my mother being domestically abused many times. I’ve been bulimic, committed suicide multiple times, severely depressed, was addicted to substances. and messed up most of my social relationships. I’m not even mad if I die early cause I feel like I’m not living my life to the fullest anyways. I hope before that I can help as many people possible with my degree. My ace score is 6. :/

  21. It shouldn't be surprising. Consider the trauma that returning soldiers suffered from the Crimean War, WWI, WWII, and so many other wars. Then consider that police officers, firefighters, and nurses among others can suffer trauma too. Then add to that the attempted cultural genocide of the Indian residential schools, then consider CPTSD caused by trans-generational trauma as a result of the parent himself suffering either PTSD or even CPTSD. We today are still suffering from generations of mass popular traumas that we need to address.

  22. No one was there for me as a kid in an abusive home.. I've attempted suicide more than once… My step kids have a very abusive mom & my bonus daughter attempted on her own life in April. Was hospitalized for 3wks in the north Bay. Lives w us now in Santa Cruz… I will be dambed if I add to her toxic stress. Tyvm. I want to be here for her.

  23. I wish this was a thing when my brother and I was growing up. My brother has passed and now, I'm suffering from autoimmune diseases, and chronic pain and depression. Furthermore no one acknowledges how this gets passed down to the next generation, for generations…..if that were the case it would provide pressident for reparations for African and indigenous people.

  24. Abuse of any type is very harmful. I still am battling with the feelings every day. My mother was my attacker. She beat me and my self confidence died. I still battle feelings of sadness today. I always wondered why she hit me so much. There were times I wanted to die. It made me wonder why she gave birth to me. On my 15th birthday I had a break down that lasted 4 months. I was locked up in an asylum. It was for chronic depression. I turned 16 in the asylum. Medicines helped me understand my pain. It's permanent damage.

  25. I cried listen to this because i went thru a lot a childhood trama from being abandoned, neglected, sexual abused, to being home when my brother commented suicide all that before I turned 16 it's definitely affected my life tremendously. But I'm trying to get back on track.

  26. Perfect way to avoid being sued by practically saying, the parents are the problem here. I love it. I have 2 kids and I refuse to use violence against them as was done to me.

  27. Amazing speech & presentation, really hit home for me. Childhood adversity needs to be noticed and addressed early, there will always be signs if you just pay attention to the child.

  28. I can't even remember my childhood, It's only filled with memories of my mom's nagging, critism, and painful words.

  29. Wow that talk hit home for me, it was awesome. I suffered at the hand of my father. He emotionally and verbally abused me . There were times when he physically abused me too, but the worst abuse was the sexual abuse. I was a sick kid. I always got colds and the flu, because of that I was off school quite often, my mum would look after me, she was a great mum, she protected me from my father. When I was 11 years old my mother died and I was left with the monster who had all the power and he used every bit of it against me. The trauma made me sick, I got every bug that was out there, I got asthma and my school work was shocking, I didn’t see why I needed to learn about people landing on the moon or algebra when I was going home to the monster.
    Hearing that kids that are abused get sicker than most, that was a wonderful eye opener for me. The thing that made me different from other kids, and I hate this difference because it still effects me today, is my economic state, my father was rich, I went to the best private schools and I even got to go to a private boarding school which was absolutely wonderful and a dream come true until the monster would ring me and make me feel so guilty to be away from him and not looking after him. No one picked up on the abuse, I was even told by a teacher that I was so lucky to be in such a loving family because my dad sent me to a private school even though my mother had passed away, she thought my dad was great. My long winded post (sorry about that) is that there are people in my situation that are falling through the cracks because they come from a wealthy family, please don’t forget about people like me. I know that most of the attention needs to be on the kids that are struggling to make ends meet, I’m not saying they are less important than me because they arent they need the help and understanding more than me what I’m trying to say is abuse happens in all groups in society, some a lot more than others and they need the care offered because they are desperate.
    I guess what I’m saying is the silent killer is out there is many groups of society. I tried to speak out once and I was laughed at and told to keep my lies to myself. Present day is a struggle for me, I have bipolar, PTSD, and crippling depression , life is a daily struggle, but I’ll get better I know I will.

  30. Fantastic insights! 76% of people have at least one childhood trauma – this proves something that I felt about society long time already. Almost everyone can tell you a story and we have to finally understand that childhood trauma is not the exception but the unfortunate rule! There is so much responsibility on the shoulders of parents and it breaks my heart when parents put their own bullshit on their little children. Work through your problem and then have children but not the other way around.

  31. Wow!!! Video was so good. I never once wanted to read the comments until after she finished. She made such phenomenal and strong points. It really affects you later in life…

  32. Thank you very much you're amazing information about the situation is very important thank you for content

  33. I’ll be watching this in-full a bit later, but from my own experience, the Title provokes an immediate response from me. I struggled as a victim of verbal & physical Bullying at Boarding-School from the age of 8yo. It followed me to Public School & I finally learnt to stand-up for myself at the age of 16yo – which was a bit too late!

    Couple that with undiagnosed A.D.D. & you get a child who was majorly depressed, from a very young age, and couldn’t understand why he was so crap at learning new stuff at School!! As a result, I chose to self-medicate with Sweets & Junk Food (Pizza) ….and then later on, Prescription Opiate Painkillers for a Back Injury! Finally something I could have total control over – my PAIN (or a major reduction in it at least!)

    Fast forward 30+ years & I get diagnosed with Bowel Cancer in April 2017. Bowel Cancer is one of the ones that is apparently caused by deep, emotional trauma! Well, that makes sense, right!? 😕

  34. As a once child now an adult that had a rough childhood. Read outwitting the devil by Napolian hill. Sometimes it starts in the womb your parents have been in a high stress environment in the womb what are your chances then?

  35. A narc mom and sister – emotional and verbal abuse gaslighting, projection, cover ups, control and manipulation. Wow she mentions pituitary – I have a pituitary tumor –

  36. "But the problem is what happens when the bear comes home every night…" this metaphor resonates with infinitely many of my childhood memories. It was a vicious cycle. I cannot describe how much I am grateful for Dr. Burke's speech on this topic since I have been having various concerning health problems but I had not ideas how I am so sick most of the time. Because of my own experience, I'm always desperate to make a difference in this world, especially for those who had/are having traumatic childhood. This speech has definitely supplied me with a new insight on this matter. It's absolutely inspiring and motivating. Thank you!

  37. I appreciate the attention given to these topics but I wish professionals would stop stigmatizing people with mental illnesses raising children. If a parent with mental illness neglects or abuses a child, it is called neglect or abuse. I am a parent with difficult mental health problems but I am a damn good mom and I work 10x as hard as any other parent to make sure my kids are happy and well adjusted. Having a parent with mental illness is not a form of trauma. Neglect and abuse on their part certainly is though.

  38. You nailed it, Dr. Harris. I was treated by a functional medicine Dr based on his full understanding of failure or dysfunction of the HPA axis. I was diagnosed with fibro, in 2013, by three Drs. One Dr. was a rheumatologist at Duke University. The functional medicine Dr who treated me stated he had never seen cortisol levels as low as mine, the lowest being a “1.” He helped heal my adrenal glands and had me try several other supplements to address my symptoms. At the end of the 6 month treatment, which insurance did not cover and cost $4,000.00, I was left with the same level of pain. I guess he had not treated a patient with such an extreme case of fibromyalgia? I thought since he understood the source of the illness, he would have a treatment protocol which would heal all my symptoms. His response to my disappointment and remaining pain was, “I’m sorry you feel that way.” When a Dr states he or she understands the cause of my illness and firmly believes he or she can heal me, but does not, how else am I to feel? This Dr completely invalidated my suffering. I suffered for 5 more years until I found an alternative healing modality which would root out the source of trauma. A QHHT session triggered the beginning of healing for me. Western medicine has yet to understand how crucial the HPA axis is in regard to treating fibromyalgia, ME/ CFS and possibly several other chronic illnesses. Thank you for discovering it and having a treatment plan in place, before chronic illness or a life threatening health issue develops. Blessings.

  39. when she said what if that bear comes home every night:( I juts imagine a kid with their little heart pounding all that stress is no good

  40. I’m so glad this lady is saying this because it’s a conclusion I’ve been thinking about recently. I believe abusive parents and parents who refuse to react properly to their own emotions, are responsible for many of the bad things in society

  41. I was molested by my two step brothers since I was 3 yrs.old , I cried for help for years to everyone and no one helped me. I grew up and stopped the abuse myself, I grew up and my ex of 17 yrs. had an affair with my real brothers wife of 20 yrs. had a baby, made my real brother think its his, so my ex and sister-in law ran off together. I gained weight from depression, raising 4 kids on my own, no child support what so ever, not even a dime..well, I got my Medical degree. I struggle everyday of my life, waking up to a reminder, so how much worse does this get? well now my mom is trying to convince my kids that I am mentally ill. Wow! I would not be like this if she would have just protected me as a child. She blames me for what happened to me as a child. I went to see a counsler for 4 years. So am I the one who is off my rocker? So now my daughter is an adult now and is my voice to expose my molesters all over facebook, now their children will know what they have done to me for years. As for my mother,.. I will never have anything to do with her ever in my life. I am still here and I am teaching my children the dangers of this world.

  42. Makes sense why at 44 they've diagnosed me with sarcoidosis, degenerative disk disease, fibromyalgia, copd,chronic pancreatitis, adhd and so much more. Daily trauma from 4to 14. Why don't doctors look at this!!!!!

  43. I wanted to get with this at first but I feel like honestly this was a
    waste of time to watch because she is being so melodramatic to me she is
    acting like every little thing is abuse and going to predispose you to
    unavoidable health risk & problems growing up.

    As someone who is mentally ill this actually pisses me off
    SIGNIFICANTLY, if you think that any form of corporal punishment is akin
    to physical abuse then you have become so liberally radical that you
    ought to have some sense knocked into you!

    Oh and just to let you know Dr. Nadine I think that she means well but
    she studies a certain pool of people and bam it is the holy grail let me
    just say something perhaps other people aren't racing to follow this
    protocol because they too can spot malarkey from a mile away!

     Ha ha as you can tell I am candid and I know for a fact that my parents
    caused me many types of agony but one thing I was sparred from was
    domestic violence and I am not in denial if I don't see it that way and
    don't feel like that and nobody ever had to intervene then enough said!

  44. Wow. I got a 100 on my A.C.E. exam, every boxed checked. I'm doomed, but I was doomed a while ago. As a result of my self-destruction I have H.I.V., kidney failure, and depression. :(. But I am finally learning to love myself and heal from my trauma.

  45. TedMed needs to translate this presentation or provide captions into other languages. There are many non-English speaking communities that can benefit.

  46. This made me emotional. My mother and her "boyfriends" were the "bears" in my life. And it still affects me to this day.

  47. This is a wonderful talk. I’m so glad to learn that she was the first Surgeon General if California. I believe that the loss of a parent to death should be added to the ACE score since it also has a profoundly negative impact on childhood development and health outcomes.

  48. Yeah, but somehow I am still okay. I put it all behind me. I don't think about it. I am happy now, and this comes from a man who's best childhood Christmas was spent in a children's home, not with any of my so-called family.

  49. Wow she's right.I'm 40 now but the list she gave I would be a 6 or 7.And I've had a heart valve and hip replacement.And I can workout myself from the past problems why.And why i am on the meds I am now.

  50. Thank you. So interesting and so much knowledge conveyed in a short lecture. Sounds obvious – once you have been told.

  51. Wait, don't tell me, blacks are exposed to more adversities than non-blacks, right?

    Hmmmm,Is this why there is now adversity scores on the S.A.T.?
    Here's a suggestion, take better care of your kids, "my brothers"………..

  52. This is kind of depressing. If you”re already an adult who experienced significant childhood trauma… doomed?

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