Nadine Burke Harris: How childhood trauma affects health across a lifetime
Nadine Burke Harris - Pediatrician
Nadine Burke Harris’ healthcare practice focuses on a little-understood, yet very common factor in childhood that can profoundly impact adult-onset disease: trauma. Full bio
that dramatically increased the risk
causes of death in the United States.
is read and transcribed.
of heart disease and lung cancer
in life expectancy.
in routine screening or treatment.
not a pesticide or a packaging chemical.
am I talking about here?
or losing a basketball game.
that are so severe or pervasive
and change our physiology:
who struggles with mental illness
I was trained to view them,
refer to social services --
refer to mental health services.
to make me rethink my entire approach.
where I felt really needed,
California Pacific Medical Center,
in Northern California,
in Bayview-Hunters Point,
neighborhoods in San Francisco.
one pediatrician in all of Bayview
to provide top-quality care
the typical health disparities:
asthma hospitalization rates,
a disturbing trend.
referred to me for ADHD,
a thorough history and physical,
for most of my patients,
had experienced such severe trauma
was going on.
I did a master's degree in public health,
in public health school
that all drink from the same well,
and write that prescription
after dose of antibiotics,
"What the hell is in this well?"
I could get my hands on
and bodies of children.
my colleague walked into my office,
have you seen this?"
of a research study
and ultimately my career.
needs to know about.
and Dr. Bob Anda at the CDC,
about their history of exposure
childhood experiences," or ACEs.
or sexual abuse;
substance dependence, incarceration;
a point on your ACE score.
against health outcomes.
had at least one ACE,
had four or more ACEs.
a dose-response relationship
the worse your health outcomes.
of four or more,
obstructive pulmonary disease
of someone with an ACE score of zero.
two and a half times.
four and a half times.
of seven or more
of lung cancer
of ischemic heart disease,
in the United States of America.
and they said, "Come on.
you're more likely to drink and smoke
that are going to ruin your health.
This is just bad behavior."
where the science comes in.
better than we ever have before
and bodies of children.
the nucleus accumbens,
center of the brain
in substance dependence.
and executive function,
in the amygdala,
to high doses of adversity
in high-risk behavior,
engage in any high-risk behavior,
to develop heart disease or cancer.
the hypothalamic–pituitary–adrenal axis,
stress response system
in the forest and you see a bear.
sends a signal to your pituitary,
to your adrenal gland that says,
fight that bear or run from the bear.
and there's a bear.
when the bear comes home every night,
over and over and over again,
adaptive, or life-saving,
to this repeated stress activation,
are just developing.
brain structure and function,
is read and transcribed.
threw my old training out the window,
the mechanism of a disease,
which pathways are disrupted, but how,
to use this science
the Center for Youth Wellness
of ACEs and toxic stress.
of every one of our kids
has an ACE score of 4,
to develop hepatitis or COPD,
to become depressed,
to attempt to take her own life
that works to reduce the dose of adversity
including home visits, care coordination,
medication when necessary.
about the impacts of ACEs and toxic stress
electrical outlets, or lead poisoning,
of our asthmatics and our diabetics
need more aggressive treatment,
and immune systems.
when you understand this science
from the rooftops,
for kids in Bayview.
that everybody else heard about this,
multi-disciplinary treatment teams,
effective clinical treatment protocols.
best clinical practice
of the American Academy of Pediatrics,
unaddressed public health threat
that's a terrifying prospect.
seems so large that it feels overwhelming
where the hopes lies,
a public health crisis,
tool kit to come up with solutions.
quite a strong track record
with ACEs and toxic stress
our nation's response has been so far,
that we marginalized the issue
in those neighborhoods.
doesn't bear that out.
was done in a population
I had it completely backwards.
how many people in this room
who suffered from mental illness,
had a parent who maybe drank too much,
if you spare the rod, you spoil the child,
that touches many of us,
that we marginalize the issue
in other zip codes
and, frankly, economic realities
health across a lifetime.
how to interrupt the progression
to disease and early death,
is not connected,
high blood pressure
as a six-month mortality from HIV/AIDS.
and say, "What the heck happened there?"
that we need today
this problem in the face
and this is all of us.
About the speaker:Nadine Burke Harris - Pediatrician
Nadine Burke Harris’ healthcare practice focuses on a little-understood, yet very common factor in childhood that can profoundly impact adult-onset disease: trauma.
Why you should listen
Pediatrician Nadine Burke Harris noticed a disturbing trend as she treated children in an underserved neighborhood in San Francisco: that many of the kids who came to see her had experienced childhood trauma. She began studying how childhood exposure to adverse events affects brain development, as well as a person’s health as an adult.
Understanding this powerful correlation, Burke Harris became the founder and CEO of the Center for Youth Wellness, an initiative at the California Pacific Medical Center Bayview Child Health Center that seeks to create a clinical model that recognizes and effectively treats toxic stress in children. Her work pushes the health establishment to reexamine its relationship to social risk factors, and advocates for medical interventions to counteract the damaging impact of stress. Her goal: to change the standard of pediatric practice, across demographics.
Nadine Burke Harris | Speaker | TED.com