Who We Are…

2. Who We Are… • Kids Oneida • Upstate Cerebral Palsy • Oneida County Planning; DSS; Health/Mental Health • SUNYIT • Utica College • Family Nurturing Center • Dr. Lark Eschelman- Patterson & Bob Patterson • Peg Zimmerman • Honorable Ralph Eannce • Robin O’Brien – USCare • Gina Ashmore – Hospice

3. The Adverse Childhood Experiences (ACE) Study • Examines the health and social effects of ACEs • throughout the lifespan among 17,421 members • of the Kaiser Health Plan in San Diego County • What do we mean by Adverse Childhood Experiences? • - childhood abuse and neglect • growing up with domestic violence, substance abuse • or mental illness in the home, parental discord, crime

4. Goals Of The Local Efforts: • Reinforce awareness • Linking ACES to physical and mental health • To ascertain perceived needs in the community and collect information on who professionals are referring to now • To solicit help and recommitment for the vulnerable youth in Oneida County

5. What Are ACES(Adverse Childhood Experiences) • Emotional/Physical Abuse • Sexual Abuse • Emotional/Physical Neglect • Domestic Violence – Battered Mother • Single Parent Homes – Due to Separation/ Divorce/Death • Substance Abuse - One or Both Parents • Incarcerated Parent(s) • Parent(s) Suffering From Mental Illness • Parent(s) Suffering From Chronic Illness

6. Adverse Childhood Experiences Are Common Household dysfunction: Substance abuse 27% Parental sep/divorce 23% Mental illness 17% Battered mother 13% Criminal behavior 6% Abuse: Emotional 11% Physical 28% Sexual 21% Neglect: Emotional 15% Physical 10%

7. Early Death Disease, Disability and Social Problems Adoption of Health-risk Behaviors Social, Emotional, & Cognitive Impairment Adverse Childhood Experiences Death Scientific gaps Conception What We Know

8. ACEs tend to come in groups… Additional ACEs (%) 1 2 3 4 >5 If you had: A battered mother 95 82 64 48 52

9. Adverse Childhood Experiences Score Trauma “Dose” Number of individual types of adverse childhood experiences were summed… ACE scorePrevalence 0 33% 1 26% 2 16% 3 10% 4 or more 16%

10. Prevalence of Childhood Abuse by Frequency of Witnessing Domestic Violence 100 Frequency of witnessing domestic violence 80 Never Once,Twice Sometimes Often 60 Very often Percent (%) 40 20 0 Emotional Physical Sexual Childhood Abuse

11. ACEs, Smoking, and Lung Disease

12. ACE Score and HIV Risks Ever Had an STD Had 50 or More Intercourse Partners Ever Injected Drugs

13. The ACE Score and the Prevalence of Severe Obesity Percent obese (%) ACE Score

14. The ACE Score and the Prevalence of Liver Disease (Hepatitis/Jaundice) Percent (%) ACE Score

15. The ACE Score and the Prevalence of Attempted Suicide Percent atempted (%) ACE Score

16. The ACE Score and a Lifetime History of Depression Percent depressed (%) ACE Score

17. ACE Score and theRisk of Being a Victim of Domestic Violence Women Men 15 10 Risk of Victimization (%) 5 0 0 1 2 3 4 >5 0 1 2 3 4 >5 ACE Score

18. ACE Score and Rates of Antidepressant Prescriptions Prescription rate (per 100 person-years) 0 1 2 3 4 >=5 ACE Score

19. ACE Score and Rates of Prescribed Antidepressant Medications by Age, 1997-2004 ACE Score 18-44 yrs ACE Score 45-64 yrs ACE Score 65-89 yrs • Relative rates are adjusted for age, sex, race/ethnicity, and education. Adults with an ACE Score of 0 are the referent.

21. Adverse Childhood Experiences • As a National Health and Economic Issue • ACEs have a strong influence on: • -adolescent health • -reproductive health • -smoking • -alcohol abuse • -illicit drug abuse • -sexual behavior • mental health • risk of revictimization • stability of relationships, homelessness • performance in the workforce

22. Adverse Childhood Experiences • As a National Health Issue • ACEs increase the risk of: • Heart disease • Chronic Lung disease • Liver disease • Suicide • - Injuries • HIV and STDs • and other risks for the leading • causes of death

23. The Adverse Childhood Experiences (ACE) Study - These strength of these findings indicate that: Adverse Childhood Experiences are a leading determinant of health and social well-being of from adolescence to late adulthood ACE Study website www.cdc.gov/nccdphp/ACE

24. Adverse Childhood Experiences Rarely Occur in Isolation… They come in groups.

25. Domestic Violence and the Risk of Other ACEs...

26. ACEs and Prescriptions for Antidepressant Medication

27. ACEs and the Risk of Domestic Violence as an Adult.. A Cycle…

28. Kids Oneida Study on Adverse Childhood Experiences 9/07

29. *3 or less indicators: 28% *4 or more indicators: 72%

30. *3 or less indicators: 30% *4 or more indicators: 70%

31. *3 or less indicators: 21% *4 or more indicators: 79%

32. Number of Open Cases 9/07 = 120 Studied

33. Of Interest: * ACE Study 14% had 4 or more ACE Indicators *ACE Study : 1 in 10 had 5 or more ACE’s *More common for indicators to occur in groups *Higher ACE score leads to health risks: -more alcohol abuse/alcohol related health issues -more tobacco-related health issues -higher risk of illicit sexual behavior and STD’s -higher risk of suicidal ideation/depression - Huge increases in cost over a a life time

34. Body Stress System

35. Stress Illness Relationships Taken from Taylor, 2006

36. Stress Illness Relationships Taken from Taylor, 2006