Exposure to trauma during childhood can create health problems throughout the life span.
Scientists have found that Adverse Childhood Experiences (ACEs) — such as abuse, neglect, divorce or having a parent who is incarcerated or struggling with addiction or mental illness — stimulate a toxic stress response that significantly increases risk for a number of chronic health conditions, including heart disease, diabetes, depression and cancer.
California Surgeon General Nadine Burke Harris, MD, MPH, who trained as a pediatrician, has devoted her career to understanding and mitigating childhood trauma and its impact on lifelong health. As surgeon general, she has made screening for and addressing ACEs among her central missions, making available $45 million in grants to support training and interventions for ACEs and toxic stress.
Among the recipients is George Slavich, PhD, and his UCLA Laboratory for Stress Assessment and Research. With $3 million in funding over three years, Dr. Slavich is leading a team of colleagues from across the state to create the California Stress, Trauma and Resilience (CAL STAR) Network, with plans to study, treat and educate health professionals and community members about toxic stress.
“One of our aims is to advance science. And the second is to educate, because, especially in the Western world, we all want to wear stress as a badge of honor,” Dr. Slavich says. “But there’s not full awareness of the downsides: the impact of stress on health and what you can do about it.”
He envisions a broad network of scientists and health care providers exploring how stress affects various body systems, from the gut to the heart to the brain, and developing precision-medicine interventions for such issues. Their discoveries will inform personalized resiliency training for high-stress volunteers throughout the state and educational materials for health care providers.
Beyond educating health professionals and medical students, Dr. Slavich hopes to develop a public online course anyone can take to learn more about stress, how to identify potentially damaging stressors and strategies for mitigating their harmful effects.
Adverse Childhood Experiences have such a powerful influence on lifelong health because the brain and immune systems are “learning systems,” Dr. Slavich says.
“Their primary job is to learn about the environment,” he says. “So if you’re in a really risky or threatening environment early on, you’re essentially tuning the brain and immune system to those frequencies. And even if you take the actual stressors away, the person is still living with that brain and immune system, meaning that the health-damaging effects of early life adversity can persist for months or years.”
As Dr. Burke Harris says: “The science is clear: Early adversity dramatically affects health across a lifetime.” The majority of Californians — 60% — report at least one ACE in their personal history, she says.
One theory for why ACEs cast such a long shadow on health has to do with inflammation. Research shows that people who have chronic disease conditions such as depression and heart disease, which are often precipitated by life stress, also have higher levels of inflammation.
“This is a very exciting time to be studying stress because we are finally beginning to understand exactly how stress affects health,” Dr. Slavich says. “Stress not only impacts the brain but also the immune system in a way that turns on inflammation, ramping it up to the point where it can increase a person’s risk for many different disorders. Stress causes inflammation, and inflammation fuels the fire.”
The CAL STAR Network launched in August and will be based in the Division of Population Behavioral Health at UCLA. Other key people on the project include Patricia Lester, MD, and Shannon Thyne, MD, at UCLA; Atul Butte, MD, PhD, and Alicia Lieberman, PhD, at UCSF; and Michael Snyder, PhD, at Stanford University.
Learn more about the Laboratory for Stress Assessment and Research at UCLA Health, or on Twitter at @UCLAStressLab.