Humboldt, Mendocino and Butte counties are the only three counties in California with more than 70 percent of their population reporting four or more adverse childhood experiences. Seventy-six percent of Humboldt and Mendocino residents, combined in the study, reported four or more ACEs. – map from hidden crises study

The residents of Humboldt and Mendocino counties are affected by a higher number of “Adverse Childhood Experiences” than any other county across the state, according to a study that surveyed occurrences of abuse, neglect and household dysfunction statewide.

The San Francisco-based Center for Youth Wellness published the ACE study — “Hidden Crisis” — which looked at four years of data gathered by the annual California Behavioral Risk Factor Surveillance System and revealed physical, mental and emotional health impacts that stem from traumatic childhood experiences.

The realization of how common ACEs are can assist in prevention and treatment of those who live with ACEs, Humboldt State Psychology Professor Tasha Howe said.

“It’s important for government agencies, politicians, social service providers and program funders to understand that we are all working with a traumatized population and this speaks to the need to become a trauma-informed community, which Humboldt is rightly doing as we speak.”

Surveys taken in Humboldt and Mendocino counties were combined in the study because the sample sizes would have been too small to be accurate if the counties were analyzed independently, according to Cecilia Chen, a policy analyst with the Center for Youth Wellness.

Demographics and physical proximity of counties was taken into consideration when counties were chosen to be combined in the study, Chen said.

In Humboldt and Mendocino counties, the combined sample size was 312, Chen said.

The data — collected through phone surveys and weighted based off the 2010 census data — revealed that 75 percent of Humboldt and Mendocino residents had experienced one or more ACEs.

Statewide, 61 percent of adults experienced one or more ACEs.

In addition, 30.8 percent of those in Humboldt and Mendocino counties had experienced four or more ACEs, compared to 16.7 percent of Californians.

Only Butte County, also a rural Northern California county, came close, with 30.3 percent of adults reporting four or more ACEs and 76.5 percent of residents reporting one or more.

Because the survey was conducted at a state level, it was not detailed enough to break down what types of ACEs were most prevalent in specific counties or what may have contributed to some counties having higher and lower numbers of ACEs, Chen said.

“We need to be doing more data collection and more community level data collection,” she said. “Over all statewide the big take away that we saw was that ACEs are really common.”

The study showed that the higher ACEs number an adult reported, the more likely to have physical health problems such as asthma, stroke, cardiovascular, kidney and Chronic Obstructive Pulmonary Disease disease. A correlation was also drawn between mental health challenges such as depression and unhealthy behaviors such as smoking, drinking and engaging in risky sexual behavior.

“People in all fields, from medicine, to social work, psychology, education and even business owners, need to understand that trauma affects people’s abilities to focus, to learn, to work, to love and to function in society,” Howe said. “If we don’t provide services to people, and preferably prevention services to prevent ACEs from occurring in the first place, the entire society suffers.”

Howe said when actions are not taken to prevent ACEs early on, the price is paid later through healthcare and incarceration costs.

The ACE study was set apart because it showed how widespread the issue of ACEs is, Howe said.

“Most studies on trauma are on populations living in poverty and focus on psychological or social outcomes,” she said.

In contrast, the Hidden Crisis study was a random phone survey, and stemmed from an original 1998 Kaiser Permanente study in which a doctor surveyed thousands of middle to upper class families with private healthcare.

“This study alerted the world to the impacts of ACEs on physical health and well-being in a middle class sample of thousands of people,” Howe said. “It alerted the medical profession to the need to take a wholistic approach and understand that mind and body are connected.”

The line the study drew between childhood traumas and physical and physiological problems later in life was a connection that most people who work in the field had already made, but the data collected supported this conclusion, Emi Botzler-Rodgers, deputy director of the Children and Family Services Humboldt County Department of Health and Human Services, said.

“It has just been very informative to what those working in this field are already thinking,” she said. “The more trauma that a child encounters the more challenges they will have.”

When a child is assessed by the Children and Family Services department any traumas in their history — and the number of ACE points — are taken into consideration, Botzler-Rodgers said.

“The study really is more of an informative resource piece that can be incorporated,” she said. “It is recognizing and acknowledging that trauma impacts health and well-being. We are looking at the trauma for the child and the family and how we can address that specifically in that situation.”

When DHHS works with a child they assess what is best for that particular child and family, taking into consideration the ACEs in that child’s life and what affects those might have, she said.

It is not uncommon for trauma to last for more than one generation, so ACEs of children and other family members are both taken into consideration, she said.

Botzler-Rodgers said she does not know why Humboldt County has a higher percentage of people with four or more ACEs than the rest of the sate.

Isolation, the nearby major prison, high rates of poverty and lack of resources and access to services could be related to the high number, Howe said.

However, there are resources available to those in Humboldt County, and the ACE study could help to gather more.

The Humboldt County Child Abuse Prevention Coordinating Council is a group dedicated to preventing ACEs before they occur, CAPCC chairwoman Cindy Sutcliffe said.

While the council was established in 1980, a recent grant from the St. Joseph Health Care Foundation has allowed the board to expand its outreach and develop new strategies for prevention, she said.

The $8,000 grant contributed to continuing public service announcements on radio and branching out to have put the announcements play in theaters before movies start. The grant also covered the expansion of an annual round table event including a webinar and funding to purchase and distribute coloring books on sexual abuse.

“Our focus is prevention and then intervention and often working with families early on,” she said.

Sutcliffe was surprised by how many ACEs Humboldt County was reported to have and said that the report could be helpful to use as a “problem statement” when seeking out future grants.

“We feel like we have had incremental success up until this year,” Sutcliffe said. “But this year we have been really branching out.”

The ACE study can help prevention associations have a better idea where to target their resources.

It also helps to better understand trauma victims and the coping mechanisms they develop, Howe said.

“When we deal with children with developmental challenges, the question changes when we know about the ACEs study,” she said. “We stop asking, ‘What is wrong with you?’ and we start asking, ‘What happened to you?’”

Contact Juniper Rose at 441-0506.

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