A conversation with CA Surgeon General Nadine Burke Harris, M.D., about ACEs and toxic stress

July 06, 2020
Area(s) of Interest: Public Health 

Adverse Childhood Experiences (ACEs) represent a public health crisis that has been, until recently, largely unrecognized by our health care system and society. ACEs affect everyone — they cross ethnic, social-economic, gender and geographic lines.

Research shows that individuals who have experienced ACEs are at significantly increased risk of serious health consequences. ACEs and toxic stress must be addressed and can be mitigated through broad screening, early detection, clinical interventions and providing other supports and resources.

With COVID-19 impacting most of society for the foreseeable future, the need to understand toxic stress and trauma-informed care has never been more critical for your patients.

The California Medical Association (CMA) is a proud partner of the ACEs Aware initiative, which provides health care providers with training, clinical protocols, and payment for screening children and adults enrolled in Medi-Cal for ACEs.

In June 2020, San Francisco pediatrician Shannon Udovic-Constant, M.D.—Vice-Chair of the CMA Board of Trustees—sat down virtually with California Surgeon General Nadine Burke Harris, M.D., MPH, to discuss the importance of the link between stress and health, particularly during a global pandemic and for communities of color.

“It’s our toxic stress response that leads to this increased risk of so many health outcomes,” explained Dr. Burke Harris. “It can impact our brain development, hormonal system, immune system – even our DNA. Interventions designed to regulate the stress response should be an important part of care.”

“COVID has actually allowed an opening for me to talk about the emotional impacts on the family,” said Dr. Udovic-Constant. “I think it’s a nice time for physicians to be moving into this screening because it’s a natural conversation as caregivers beyond the normal definition of health.”

View the full conversation here, and get trained today.

Reminder: Effective July 1, physicians must complete training to continue being reimbursed for ACEs screenings

Over the coming months, CMA will continue to share the latest ACEs resources, news and education, so be sure to subscribe to CMA’s various publications, and follow the conversation online with #ACESaware.


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