California state ACE program unveils public awareness campaign to boost message that children are highly fragile
May 30, 2024
CATEGORY: GOVERNMENT PROJECTS
Left: Nadine Burke Harris, MD, former California Surgeon General. Right: Diana Ramos, M.D., current California Surgeon General
Source: Office of California Surgeon General press release
Read time: 2.7 minutes
This Happened
On May 1, 2024, the Office of the California Surgeon General announciedthe launch of the Live Beyond campaign to increase awareness and understanding of Adverse Childhood Experiences (ACEs) and toxic stress.
Who Did This?
The Office of the California Surgeon General runs the state’s program to improve the health of citizens by warning them of the presumed dangers of ACEs. The ACE program was started under the inaugural Surgeon General, Nadine Burke Harris, M.D. who served 2019-2022. She is a pediatrician and has a master of public health degree. Harris stepped down in 2022 but continues her advocacy for ACEs independently.
Diana Ramos, M.D. has been Surgeon General since 2022. She is an obstetrician, has a master of public health degree, and advocates for equity.
The Premise
The study that started the ACE movement was published in 1998. This study retrospectively reviewed patient charts and found a correlation between the number of ACEs and physical diseases including heart disease, cancer, lung disease, and obesity [1]. The advocates of ACE made a leap in interpretation to claim that ACEs cause these diseases rather than just being associated for other reasons. Dozens of similar studies have since been conducted that keeps increasing the number of linked physical disease outcomes. As the graphic below shows, the California program makes the claim that the effects of ACEs make individuals more likely to develop 9 of the 10 leading causes of death [2].
Read time: 2.7 minutes
This Happened
On May 1, 2024, the Office of the California Surgeon General announciedthe launch of the Live Beyond campaign to increase awareness and understanding of Adverse Childhood Experiences (ACEs) and toxic stress.
Who Did This?
The Office of the California Surgeon General runs the state’s program to improve the health of citizens by warning them of the presumed dangers of ACEs. The ACE program was started under the inaugural Surgeon General, Nadine Burke Harris, M.D. who served 2019-2022. She is a pediatrician and has a master of public health degree. Harris stepped down in 2022 but continues her advocacy for ACEs independently.
Diana Ramos, M.D. has been Surgeon General since 2022. She is an obstetrician, has a master of public health degree, and advocates for equity.
The Premise
The study that started the ACE movement was published in 1998. This study retrospectively reviewed patient charts and found a correlation between the number of ACEs and physical diseases including heart disease, cancer, lung disease, and obesity [1]. The advocates of ACE made a leap in interpretation to claim that ACEs cause these diseases rather than just being associated for other reasons. Dozens of similar studies have since been conducted that keeps increasing the number of linked physical disease outcomes. As the graphic below shows, the California program makes the claim that the effects of ACEs make individuals more likely to develop 9 of the 10 leading causes of death [2].
The 10 ACEs are:
Emotional, verbal abuse
Physical abuse
Sexual abuse
Emotional neglect
Physical neglect
Divorce / abandoned by parent
Domestic violence
Parental substance abuse
Parental mental illness
Family member went to prison
California initiated the program in 2020 with the ACEs Aware initiative, a first-in-the-nation attempt to pay primary care providers to screen for the 10 ACE events in children and adults. At the time, Nadine Burke Harris set a goal to reduce ACEs and toxic stress by half in one generation [3]. Their February 2024 update boasted that over 1.5 million individuals had been screened for ACEs from January 1, 2020 to October 31, 2023. The report also asserted that the program made a difference in clinical care but did not report any details [4].
The next phase of the program is the $24 million Live Beyond initiative, which is principally a public relations campaign aimed at 16-25 year-olds. By providing an informational website, social content on Instagram, Facebook, and TikTok, and inspirational stories of healing, the Live Beyond campaign hopes to prevent future ACEs.
Analysis
The ACE campaign is based on the premise that you can prevent stress life events by handing out a screen at a doctor visit. One of the co-authors of the 1998 study, Robert Anda, and others, however, voiced their opposition and warned against screening [5].
It is implausible to believe that giving a screen, which may or may not be followed by brief counsel from a doctor about community resources, can prevent ACEs. If it were that simple, complex societal problems would have been shrunk a long time ago.
The underlying premise of ACEs is flawed because the studies are flawed. They are cross-sectional and have zero ability to explain causal relationships. Rather than ACEs causing physical diseases, it is more plausible that family settings where ACEs are more likely to happen are the same family settings where worse physical health outcomes are likely to happen. Neither one causes the other. They co-occur in families because bad things in life do not usually happen at random due to complex genetic and heritable reasons.
ACE advocates claim that their science cannot be challenged because it is based on a scientific consensus. The problem with that claim is that the field of scholars in academia has become over the past sixty years a self-selected group who are highly skewed toward progressive leftist ideology [6]. The skew is probably even more prominent in leaders of national organizations that produce the consensus statements.
Why Is This Happening?
The likely true purpose of the campaign is to maintain and tighten control of a public narrative supporting the ideology that humans are highly malleable and children are highly fragile. Hence, rather than promoting nuclear families and self-reliance, the ACE narrative is important for supporting progressive leftist government entitlement programs—under the guise of public health— to make the world a better place.
REFERENCES
[1] Vincent J. Felitti et al. "Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study," American Journal of Preventive Medicine 14 (1998): 245-258.
[2] Live Beyond website. Accessed May 30, 2024. https://livebeyondca.org/parents-caregivers/
[3] Press release, December 9, 2020. Office of the California Surgeon General. https://osg.ca.gov/wp-content/uploads/sites/266/2020/12/PRESS-RELEASE_SG-REPORT_ACES_TOXIC-STRESS_12092020.pdf
[4] Quarterly Progress Update, February 2024. Office of the California Surgeon General. https://www.acesaware.org/wp-content/uploads/2024/01/ADA_Feb_2024_Quarterly_Progress_Report_01172024.pdf
[5] Robert F. Anda, Laura E. Porter, David W. Brown Inside the Adverse Childhood Experience Score: Strengths, Limitations, and Misapplications. American Journal of Preventive Medicine 2020;59(2):293−295; https://doi.org/10.1016/j.amepre.2020.01.009
John D. McLennan, Andrea Gonzalez, Harriet L. MacMillan, Tracie O. Afifi, Routine screening for adverse childhood experiences (ACEs) still doesn't make sense, Child Abuse & Neglect, 2024, https://doi.org/10.1016/j.chiabu.2024.106708
[6] Mitchell Langbert (2018). Homogenous: The Political Affiliations of Elite Liberal Arts College Faculty. Academic Questions 31:186-197. doi 10.1007/s12129-018-9700-x
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Emotional, verbal abuse
Physical abuse
Sexual abuse
Emotional neglect
Physical neglect
Divorce / abandoned by parent
Domestic violence
Parental substance abuse
Parental mental illness
Family member went to prison
California initiated the program in 2020 with the ACEs Aware initiative, a first-in-the-nation attempt to pay primary care providers to screen for the 10 ACE events in children and adults. At the time, Nadine Burke Harris set a goal to reduce ACEs and toxic stress by half in one generation [3]. Their February 2024 update boasted that over 1.5 million individuals had been screened for ACEs from January 1, 2020 to October 31, 2023. The report also asserted that the program made a difference in clinical care but did not report any details [4].
The next phase of the program is the $24 million Live Beyond initiative, which is principally a public relations campaign aimed at 16-25 year-olds. By providing an informational website, social content on Instagram, Facebook, and TikTok, and inspirational stories of healing, the Live Beyond campaign hopes to prevent future ACEs.
Analysis
The ACE campaign is based on the premise that you can prevent stress life events by handing out a screen at a doctor visit. One of the co-authors of the 1998 study, Robert Anda, and others, however, voiced their opposition and warned against screening [5].
It is implausible to believe that giving a screen, which may or may not be followed by brief counsel from a doctor about community resources, can prevent ACEs. If it were that simple, complex societal problems would have been shrunk a long time ago.
The underlying premise of ACEs is flawed because the studies are flawed. They are cross-sectional and have zero ability to explain causal relationships. Rather than ACEs causing physical diseases, it is more plausible that family settings where ACEs are more likely to happen are the same family settings where worse physical health outcomes are likely to happen. Neither one causes the other. They co-occur in families because bad things in life do not usually happen at random due to complex genetic and heritable reasons.
ACE advocates claim that their science cannot be challenged because it is based on a scientific consensus. The problem with that claim is that the field of scholars in academia has become over the past sixty years a self-selected group who are highly skewed toward progressive leftist ideology [6]. The skew is probably even more prominent in leaders of national organizations that produce the consensus statements.
Why Is This Happening?
The likely true purpose of the campaign is to maintain and tighten control of a public narrative supporting the ideology that humans are highly malleable and children are highly fragile. Hence, rather than promoting nuclear families and self-reliance, the ACE narrative is important for supporting progressive leftist government entitlement programs—under the guise of public health— to make the world a better place.
REFERENCES
[1] Vincent J. Felitti et al. "Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study," American Journal of Preventive Medicine 14 (1998): 245-258.
[2] Live Beyond website. Accessed May 30, 2024. https://livebeyondca.org/parents-caregivers/
[3] Press release, December 9, 2020. Office of the California Surgeon General. https://osg.ca.gov/wp-content/uploads/sites/266/2020/12/PRESS-RELEASE_SG-REPORT_ACES_TOXIC-STRESS_12092020.pdf
[4] Quarterly Progress Update, February 2024. Office of the California Surgeon General. https://www.acesaware.org/wp-content/uploads/2024/01/ADA_Feb_2024_Quarterly_Progress_Report_01172024.pdf
[5] Robert F. Anda, Laura E. Porter, David W. Brown Inside the Adverse Childhood Experience Score: Strengths, Limitations, and Misapplications. American Journal of Preventive Medicine 2020;59(2):293−295; https://doi.org/10.1016/j.amepre.2020.01.009
John D. McLennan, Andrea Gonzalez, Harriet L. MacMillan, Tracie O. Afifi, Routine screening for adverse childhood experiences (ACEs) still doesn't make sense, Child Abuse & Neglect, 2024, https://doi.org/10.1016/j.chiabu.2024.106708
[6] Mitchell Langbert (2018). Homogenous: The Political Affiliations of Elite Liberal Arts College Faculty. Academic Questions 31:186-197. doi 10.1007/s12129-018-9700-x
You can subscribe to our email newsletter by clicking on Trauma Dispatch in the menu bar at the top of this page.