In the late 1990s, U.S. health maintenance organization Kaiser Permanente conducted a 17,000-person study linking adverse childhood experiences (ACEs) with poor health outcomes later in life. The study, known as the ACE Study, looked at ten specific types of adverse childhood experiences, including physical abuse, sexual abuse, household mental illness and more and found that the more ACEs a study participant had, the poorer their health outcome.

The ACE study opened a new line of thinking for doctors and public health officials, including one California pediatrician who made it her mission to raise awareness about ACEs and to fight them as a preventive health measure. Inspired, that pediatrician, Dr. Nadine Burke Harris, co-founded the Center for Youth Wellness, a clinical practice which considered patients’ ACEs scores and included mind-body remedies as part of wellness.

Then, in 2014, dressed in a bright red dress and heels, Burke Harris gave an accessible and resonant TED Talk about ACEs, using stories from her practice at the Center for Youth Wellness. The talk caught fire, reaching over 2.8 million viewers, and skyrocketed the pediatrician into becoming the foremost spokesperson on ACEs. It also raised awareness about the link between trauma and health among the public like no other time in the past.

With a growing body of research to back her messaging about ACEs, Burke Harris then published her book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity in 2018, which not only illustrated the impact of ACEs, but also considered broader societal issues like racism and violence and the impact those have on public health. Steadily, the message that protecting children from trauma could be the answer to stubborn public health problems was beginning to take hold.

Then in February of this year, Governor Gavin Newsom appointed Burke Harris to become California’s first-ever Surgeon General, giving her a powerful platform to act — statewide — to address ACEs. Her appointment, as well as her work around ACEs, made national news, and in every interview, she raised awareness about childhood trauma, and how protecting kids is vital to their future health.

In her new role the Surgeon General has pushed to implement a pediatric ACEs screening for all children, a move that many throughout the nation think should be a model for all well-child visits.Starting in 2020, to help doctors understand how a child’s circumstances may be impacting their health, California’s kids will be screened for ACEs.

As Burke Harris uses her powerful new role to change California’s understanding of disease and trauma, we have compiled links to the many articles written about her, as well as the ACEs screening tool, and the link between ACEs and public health. We have also included links to pieces written about the Trump Administration’s family separation policy, which has caused widespread trauma for immigrants. We hope this trove of article links helps readers be informed of her work, and awareness around ACEs.

Nadine Burke Harris’s Appointment as Surgeon General

Gov. Gavin Newsom: Governor Newsom Announces Two National Experts in Child Development will be Key Leaders in Administration’s Efforts to Help the Youngest Californians
Dr. Nadine Burke Harris will be California’s first-ever Surgeon General. Kris Perry will be Deputy Secretary of the California Health and Human Services Agency for Early Childhood Development and Senior Advisor to the Governor on Implementation of Early Childhood Development Initiatives. (1/21/2019)

California Health Report: Appointment of New Surgeon General Puts Spotlight on Early Childhood Adversity
The impact of stress and trauma on people’s physical and mental health looks set to become a central focus of Gov. Gavin Newsom’s administration in the wake of his appointment of the state’s first surgeon general. (Boyd-Barrett, 1/24/19)

Quartz: California’s new surgeon general changed the way we understand childhood trauma
Years of treating underprivileged kids in Bayview-Hunters Point, one of San Francisco’s poorest neighborhoods, had shown her that the kids with the most severe history of trauma often exhibited the worst symptoms. (Timsit, 1/24/19)

Chronicle for Social Change: California Governor Names Nadine Burke Harris as State’s First-Ever Surgeon General
Newsom’s appointment of Burke Harris comes on the heels of his opening budget proposal, which includes several proposed investments in early intervention and prevention supports and services. (Loudenback, 1/23/19)

KPBS: California’s First Surgeon General Takes Aim at ‘Toxic Stress’
California has never had a Surgeon General, but that will change today. Dr. Nadine Burke Harris, a San Francisco-based pediatrician, has pioneered research into the effect childhood traumas have on health. (Orr, 2/11/19)

LAist: Toxic Stress Is The Hidden Public Health Crisis California’s New Surgeon General Wants To Solve
California’s new, first-ever surgeon general, Dr. Nadine Burke Harris, has made the link between childhood adversity and long-term health the focus of her work. (Neely, 2/20/19)
Also featured in KPCC Take Two (Rodriguez, 2/20/19)

Modern HealthCare: Q&A: California’s new surgeon general aims to make early health interventions a priority
Dr. Nadine Burke Harris has been on a mission to raise awareness about the impact toxic stress and trauma can have on children. (Johnson, 3/2/19)

California Healthline: California Looks To Lead Nation In Unraveling Childhood Trauma
With Burke Harris’ selection as the state’s first surgeon general, California is poised to become a vanguard for the nation in embracing the research that traces adverse childhood experiences, or ACEs, to the later onset of physical and mental illness. (Barry-Jester, 3/5/19)

Vice: California Has an Innovative Plan to Deal With Childhood Trauma
California’s first-ever surgeon general Nadine Burke Harris is spearheading a movement for the state to become a leader in tracing adverse childhood experiences, or ACEs, to the onset of physical and mental illness. (Barry-Jester, 3/5/19)

ProHealth: Unraveling Childhood Trauma
Dr. Nadine Burke Harris, California’s newly appointed surgeon general, is a leading voice in a movement trying to transform our understanding of how the traumatic experiences that affect so many American children can trigger serious physical and mental illness. With her, California is poised to become a vanguard for the nation in embracing the research that traces adverse childhood experiences, or ACEs, to the later onset of physical and mental illness. (Barry-Jester, 3/12/19)

California Health and Human Services Agency (Press Release): California Surgeon General Dr. Nadine Burke Harris Launches Statewide Listening Tour
California Surgeon General Dr. Nadine Burke Harris launched today a statewide listening tour at Fruit Ridge Community Collaborative (FRCC) in Sacramento to raise awareness about the link between Adverse Childhood Experiences, toxic stress and serious health conditions. (4/2/19)

Sacramento Bee: State surgeon general’s prescription for a healthy Sacramento: Alleviating childhood trauma
Dr. Nadine Burke Harris told The Bee that capital residents are powerfully grappling with the long-term impact childhood trauma has on their families and neighborhoods. (Anderson, 4/3/19)

The Orange County Register: California’s first surgeon general prioritizes children and addressing health disparities
Addressing the adverse physical and mental repercussions of childhood trauma has been the highlight of Dr. Nadine Burke Harris’s career as a pediatrician. And it’s an issue that will take center stage during her tenure as California’s first-ever surgeon general. (Bharath, 4/5/19)

Capitol Public Radio: Interview: California’s First Surgeon General, Dr. Nadine Burke Harris, On Childhood Trauma And Her New Role
Dr. Burke Harris joined Insight Tuesday to talk about her newly created office and her plans to address healthcare issues in underserved communities across California. Here are some of the highlights. (Caiola, 4/16/19)

KPCC: California’s new surgeon general visits a Watts early education center
Governor Gavin Newsom proclaimed April 30 as El Día de los Niños, Children’s Day. In recognition, California’s newly-appointed surgeon general, Dr. Nadine Burke Harris, visited Locke Early Education Center in Watts to read to students and hear the concerns of staff. (Neely, 5/1/19)

LAist: Governor Gavin Newsom Has An Army Of Early Childhood Advisors. Meet One Of Them.
Newsom is putting together a veritable army of advisors specializing in early childhood throughout his administration. His chief of staff is a nationally recognized expert on early childhood policy, he has an early education advisor in his office, and he appointed the state’s first-ever surgeon general who is focused on reducing childhood trauma. (Neely, 5/9/19)

EdSource: California wants to find out if you — or your kids — have experienced trauma
The new screenings are part of a push by Gov. Gavin Newsom to focus on adverse childhood experiences, underscored by his appointment of Dr. Nadine Burke Harris as California’s first surgeon general earlier this year. (Stavely, 6/25/19)

Education Dive: California doctors to begin screening children for trauma
California pediatricians will begin screening children for traumatic experiences beginning Jan. 1, 2020. Gov. Gavin Newsom’s surgeon general, Dr. Nadine Burke Harris, is considered an authority on how childhood trauma can adversely affect brain development, EdSource reports. (DeLaRosa, 6/27/19)

NPR: California’s 1st Surgeon General Spotlights Health Risks Of Childhood Adversity
Not long after she finished her medical residency at Stanford University about a decade ago, Nadine Burke Harris got to work as a pediatrician in the Bayview-Hunters Point neighborhood of San Francisco. (Stallings, 7/2/19)

The Washington Post (VIDEO): Opinion | Childhood trauma is a public health threat. Our kids deserve better.
Migrant children being separated from their parents, students surviving a school shooting, kids growing up in homes with substance abuse or mental illness are all at risk. But Nadine Burke Harris, California’s surgeon general, says there is hope. (7/5/19)

The Washington Post: Whom do we call to report the mistreatment of children by the federal government?
Children in dirty clothes who haven’t been bathed in days. Eight-year-olds caring for toddlers out of necessity. Kids deprived of the safe, stable and nurturing care that’s fundamental to their health and well-being. (Burke Harris, 7/11/19)

VICE: A Black Immigrant Woman Is Now the Most Powerful Health Official in California
And Nadine Burke-Harris is focusing her work on toxic stress. (Morgan, 7/18/19)

NBC News: California’s first surgeon general: Screen every student for childhood trauma
Dr. Nadine Burke Harris has an ambitious dream: screen every student for childhood trauma before entering school. (Gaines, 10/11/19)

Santa Fe New Mexican: Consequences of childhood trauma are costly
A network news headline came across the internet that caught our eyes: “California’s first surgeon general: Screen every student for childhood trauma.” The quote was attributed to one of the strongest advocates for addressing the epidemic of childhood trauma, Dr. Nadine Burke Harris. (Courtney, 11/9/19)

Chicago Tribune: Why the nation should screen all students for trauma like California does
As the first person to hold the new role of Surgeon General of California, Dr. Nadine Burke Harris is pushing an unprecedented plan to implement universal screenings for childhood trauma within the state’s school. (Shin, 11/18/19)

Screening

AAP News & Journals: Validation of the Traumatic Events Screening Inventory for ACEs
Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. (3/4/19)

ACES Connection: As California Moves to Screen Children for Childhood Trauma, Poverty Has To Be Part of the Equation
Since the original ACE study, some researchers have added “poverty” and other social inequities such as homelessness to the list of ACEs that can result in lifelong harm to health. (Hickman, 5/9/19)

Education Dive: California doctors to begin screening children for trauma
California pediatricians will begin screening children for traumatic experiences beginning Jan. 1, 2020. Gov. Gavin Newsom’s surgeon general, Dr. Nadine Burke Harris, is considered an authority on how childhood trauma can adversely affect brain development, EdSource reports. (DeLaRosa, 6/27/19)

Chronicle for Social Change: California’s Surgeon General Readies Statewide Screening for Child Trauma
As she prepares to put California’s ACEs screening process in motion, Harris talked with The Chronicle of Social Change about Newsom’s agenda, plans for a statewide screening process, and how doctor shortages are affecting children’s health. (Loudenback, 9/18/19)

Child Trends: Childhood adversity screenings are just one part of an effective policy response to childhood trauma
As state officials across the United States consider expanding the use of screening to identify and respond to childhood trauma in individual children, a new brief from Child Trends warns against over-reliance on these screenings and recommends an alternative approach. (Murphey, Bartlett, 11/9/19)

Child Separation and Trauma

Houston Public Media: Doctors Say Kids Separated From Parents At Border Face ‘Toxic Stress,’ Serious Health Risks
“When kids are going through stressful situations, being kept together with their parents or their caregivers is actually critically important to prevent these long-term health problems,” Dr. Nadine Burke Harris says. (6/8/18)

ABC News: Separated migrant families demand millions from US agencies
Lawyers for eight immigrant families separated under Trump administration policy have filed claims with the U.S. government demanding $6 million each in damages for what they described as lasting trauma. (Mechant, 2/11/19)

AAP News & Journals: Validation of the Traumatic Events Screening Inventory for ACEs
Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. (3/4/19)

The New Yorker: The Lasting Trauma of Mothers Separated from Their Nursing Children
Over the summer, when the Trump Administration was taking children from their parents at the southern border, there were reports of at least two breast-feeding infants who had been seized from their mothers. (11/16/18)

TIME: How Traumatized Children See the World, According to Their Drawings
Toxic stress during childhood can last a lifetime — but it doesn’t have to. (11/14/18)

The Washington Times: Official who oversaw migrant kids: Separation causes trauma
The Health and Human Services official responsible for helping to reunite families separated by the Trump administration said Thursday he had warned colleagues that separating children from their parents would cause lasting, serious psychological trauma. (Long, 2/7/19)

American Medical Association: Congress told impact of immigrant children’s trauma may be lifelong
AMA urges Congress and the Trump administration to work with medical and mental health experts to ensure that the health of families and children seeking refuge in the U.S. is protected throughout the immigration process. (Robeznieks, 7/12/19)

ACEs and Public Health

Capital Public Radio: How Governor Gavin Newsom’s Plan To Identify Early Childhood Trauma In Kids Might Make Healthier, Smarter Students
First 5 programs, which use state and county funds to support low-income families with young children, already screen for this type of trauma during home visits. But Erin Gabel, a deputy director of First 5 California, said the governor’s proposal could go a long way toward making this more widespread. (Caiola, 1/14/19)

AAP News: ACEs linked to higher health care costs in adulthood
Previous studies have found links between adverse childhood experiences (ACEs) and later physical and mental health problems. Authors set out to look at the impact on costs associated with those issues. in adulthood. (6/14/19)

Brookings: From trauma-informed to asset-informed care in early childhood
The focus on “toxic stress,” ACEs (Adverse Childhood Experiences), and trauma-informed care have been game-changers in the field of early childhood development. (Galinsky, 10/23/19)

The Chronicle for Social Change: New Report Links Adverse Childhood Experience to Leading Causes of Death
Earlier this week a report released by the Centers for Disease Control and Prevention (CDC) linked Adverse Childhood Experiences (ACEs) to several leading causes of death in the country, including heart disease, cancer, respiratory disease, diabetes and suicide. (Phagan-Hansel, 11/8/19)

EurekAlert: Childhood adversity linked to higher out-of-pocket health care costs in adulthood
A study has found that out-of-pocket health care spending and medical debt are substantially higher when adults have a history of adverse childhood experiences. (3/21/19)
Also featured in Healio (3/21/19)

Science Daily: Childhood trauma has lasting effect on brain connectivity in patients with depression
A study found that childhood trauma is linked to abnormal connectivity in the brain in adults with major depressive disorder (MDD). The paper shows symptom-specific, system-level changes in brain network connectivity in MDD. (4/8/19)

Medical Xpress: Responding to adverse childhood experiences – An evidence review
“By bringing together an extensive and complex evidence base, we have drawn out seven key themes from the literature which are common and important when it comes to prevention and mitigation of the harms from adversity across the life course”.(5/17/19)

CityLab: How Does Toxic Stress Affect Low-Income and Black Children?
Traumatic childhood experiences can harm children’s ability to learn reading, writing, and math, according to a new report. (Dilday, 5/8/19)

World Health Organization: Preventable trauma in childhood costs north America and Europe US$ 1.3 trillion a year
The findings of a new study on the life-course health consequences and associated annual costs of adverse childhood experiences (ACEs) show that preventable trauma in childhood costs north America and the European Region US$ 1.3 trillion a year. (9/4/19)

NPR: Positive Childhood Experiences May Buffer Against Health Effects Of Adverse Ones
Plenty of research shows that adverse childhood experiences can lead to depression and other health problems later in life. But researcher Christina Bethell wondered whether positive experiences in childhood could counter that. Her research comes from a personal place. (Simmons-Duffin, 9/9/19)
Also featured in Reuters (Rapaport, 9/9/19)

EurekAlert: For kids who face trauma, good neighbors or teachers can save their longterm health
Previous studies found having adverse childhood experiences can lead to poor health outcomes later in life. New BYU research finds the anecdote is to counter those with enough positive experiences. (9/16/19)

Psychology Today: How Adverse Childhood Experiences Cost $1.33 Trillion a Year
Research takes a deep dive into large-scale impact of harm to children. (Iati, 9/14/19)

The Chronicle of Social Change: Kaiser Permanente Investing Millions to Advance Research on Adverse Childhood Experiences
Last week Kaiser Permanente announced it would invest $2.75 million in research to mitigate the effects of adverse childhood experiences. (Phagan-Hansel, 10/17/19)

NPR: CDC: Childhood Trauma Is A Public Health Issue And We Can Do More To Prevent It
Childhood trauma causes serious health repercussions throughout life and is a public health issue that calls for concerted prevention efforts. That’s the takeaway of a report published Tuesday from the Centers for Disease Control and Prevention. (Chatterjee, 11/5/19)

Big Think: Why victims of childhood adversity have a harder time achieving their goals
Childhood trauma can affect a child’s brain in dramatic ways for the rest of their lives. (12/13/18)

Medical Xpress: Responding to adverse childhood experiences – An evidence review
“By bringing together an extensive and complex evidence base, we have drawn out seven key themes from the literature which are common and important when it comes to prevention and mitigation of the harms from adversity across the life course”. (5/17/19)

CityLab: How Does Toxic Stress Affect Low-Income and Black Children?
Traumatic childhood experiences can harm children’s ability to learn reading, writing, and math, according to a new report. (Dilday, 5/8/19)

Center for Health Journalism: Why we should think critically when reporting on childhood adversity
What do juvenile crime, high medical costs, and short life spans all have in common? If you believe recent health reporting on these and dozens of other topics, all of these can be traced back to something traumatic that happened to people when they were young. (Heisel, 6/26/19)

The Washington Post (VIDEO): Opinion | Childhood trauma is a public health threat. Our kids deserve better.
Migrant children being separated from their parents, students surviving a school shooting, kids growing up in homes with substance abuse or mental illness are all at risk. But Nadine Burke Harris, California’s surgeon general, says there is hope. (7/5/19)




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