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Presentation DR. RENAISA ANTHONY, MD, MPH Deputy Director, Center - - PowerPoint PPT Presentation

Jun 10, 2023 450 likes •986 views

Presentation DR. RENAISA ANTHONY, MD, MPH Deputy Director, Center for Reducing Health Disparities University of Nebraska Medical Center Adverse Childhood Experiences (ACE Scores) Theory, Application & Implementation Renaisa S. Anthony MD,

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Presentation

  • DR. RENAISA ANTHONY, MD, MPH

Deputy Director, Center for Reducing Health Disparities University of Nebraska Medical Center

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Renaisa S. Anthony MD, MPH

Deputy Director/Assistant Professor Center for Reducing Health Disparities College of Public Health (402) 559-9660 January 11, 2017

Adverse Childhood Experiences (ACE Scores) Theory, Application & Implementation

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I Am:

  • Licensed practicing physician by training
  • Public health practitioner by passion
  • Deputy Director of the CRHD
  • Founding MCH Faculty
  • Professor/Faculty Member UNMC
  • Honored to be here with you!
  • Caring for women & patients for 10+ years
  • Doctor/patient relationship (backstage pass)
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Who Are You? Where do you make an impact?

  • Health Care Professionals (direct service)
  • Public Health Practitioners
  • Health Departments
  • Other Government/Policy Organizations
  • Other Non-Profit Organizations
  • Academic/Researchers
  • Administrators
  • Kansas (urban, rural, other)

Who is passionate about women, children and adolescents? MCH?

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Pop Quiz: What is?

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MODIFIABLE

  • Zip Code/Neighborhood
  • Educational attainment
  • Employment status
  • Socioeconomic status
  • Social environment
  • Resources

NON MODIFIABLE

  • gender, race, ethnicity and age

OTHERS (may or may not be modifiable)

  • culture, religion individual but also societal level

Social Determinants

Where you live, work, play and pray makes a tremendous impact on health and long term life outcomes.

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Also what you experienced before the age of 18…makes a significant impact Unfortunately, children DO NOT Start at the same Start Line

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Adverse Childhood Experiences

  • Chronic, toxic stress and childhood trauma impact the development
  • f children into adolescence and across the life course.
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The Ace Study

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http://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and- learn-what-it-does-and-doesnt-mean

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THE DATA

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The ACE Pyramid: Theoretical Framework

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Childhood Experiences Underlie Chronic Depression

10 20 30 40 50 60 70 80 % With a Lifetime History of Depression 1 2 3 >=4 ACE Scores Women Men

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ACE Score vs. Unintended Pregnancy or Elective Abortion

10 20 30 40 50 60 70 80

% have Unintended PG, or AB

1 2 3 4 or more

ACE Score

Unintended Pregnancy Elective Abortion

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Childhood Experiences Underlie Later Suicide

5 10 15 20 25 % Attempting Suicide

ACE Score

0 1 2 3 >=4

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What happens to these children? What determines their outcomes?

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What happens to these children? What determines their outcomes?

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34 From Neal Halfon

Influences Over the Life Course

Risk vs. Protective Factors:

Drinking alcohol Smoking tobacco Sexual promiscuity Using drugs Overeating/eating disorders Delinquent behavior Poor Impulse Control Self inflicted harm (self injury) Relationship Trauma and more…..

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40 Developmental Assets

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40 Developmental Assets

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Resilience

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Positive Deviance

  • What is wrong is always available but so is what

is right!

  • In every community there are individuals or

groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers, while having access to the same resources. Adverse Childhood Experiences, 40 Developmental Assets, Resilience,

  • Coping. Protective Factors Can

Mitigate ACEs

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HOW CAN YOU APPLY THIS FOR YOUR POPULATION & KEY STAKEHOLDERS

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Prevention & Lifecourse Model

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How I Use: (RECIPE)

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Trauma Informed Care http://www.traumainformedcareproject.org/

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Reproductive Life Planning! http://www.cdc.gov/preconception/reproductiveplan.html

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FP: Contraception

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Bedsider.org

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Policy/Advocacy

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Preconception & Interconception

http://www.cdc.gov/preconception/index.html

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Centering Pregnancy

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Unnatural Causes: When the Bough Breaks

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Poverty Simulator playspent.org

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Bridges Out of Poverty

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Collaboration: Academic Partners

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Socio-ecological model (SEM)

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Other

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https://www.youtube.com/watch?v=yQrBCJpTewc

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So What Will You Do? How can & will you use this?

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Just maybe?

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Renaisa S. Anthony MD, MPH University of Nebraska Medical Center Center for Reducing Health Disparities College of Public Health Renaisa.anthony@unmc.edu 402 559-9660

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