The Cost of Trauma

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For the last few weeks I have been putting together a presentation I will be making at a local university to some students and professionals who work with children and youth. My goal is to impress on them that trauma needs to be viewed as a major public health issue. The question is, how do I get their attention?

One idea is to note what the World Health Organization recently presented with regard to the economic cost of trauma worldwide. It seems a shame to have to boil some things down to money, and at the same time we know that money speaks in ways that information and research about emotional health and the impact of trauma on the brain cannot.

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So much data has been collected in recent years that is based on the Adverse Childhood Experiences research done through Kaiser Permanente and the Center for Disease Control. While the ACEs research is not perfect – something acknowledged by its co-authors, Drs. Robert Anda and Vincent Felitti – it gives a window on the power of traumatic experiences that occur during childhood that greatly impact health outcomes later in life.

The ACEs statistics are powerful and overwhelming. This includes major increases in things like the early onset of heart disease, cancer, diabetes and COPD as well as a 12 times greater probability for suicide attempts for those with four or more ACEs. For more information, check out the Nadine Burke Harris Ted talk, the ACEs Connection website along with the CDC.

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The World Health Organization took on the enormous task of trying to analyze data from ACEs research to determine the economic impact annually that child adversities have in terms of the health costs related to these adversities. The results are staggering! According to their report published in The Lancet in September, 2019 entitled Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences across Europe and North America: A Systematic Review and Meta-Analysis the annual health and financial costs accrued because of ACEs is $1.3 trillion per year in North America and Europe! [$581 billion in Europe and $748 billion in North America.] 

The article goes on to say, “Millions of adults across Europe and north America live with a legacy of ACEs. Our findings suggest that a 10% reduction in ACE prevalence could equate to annual savings of 3 million DALYs [Disability-Adjusted Life Years] or $105 billion.”

Any of us who study trauma and its impact have come to realize that the toll on human life, and the quality of that life, is enormous. Having data like this can help us all have something concrete that validates what we intuitively know about the price trauma exacts on the human soul, on individuals, families, communities, and whole systems.

The questions I will be proposing to my audience: how does this kind of information impact us? What are our responsibilities knowing this type of information?

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For many years we have been learning that there is a raging, out-of-control fire called trauma and childhood adversity that is spreading its destruction wherever it goes. Up until now I think we have been battling this fire by throwing mere bucketsful of water on it in terms of promoting education around trauma and developing effective interventions. While we are beginning to address the needs of trauma-impacted children and adults, we are not putting enough money into serious, effective ways to prevent childhood adversities in the first place.

I know we could do it if we would get serious about addressing this raging fire in ways that can at the very least contain and then further reduce traumatic adversity so that it is no longer devastating millions of children and adults every year. I have personally seen the effects of professionals attending our trauma courses and becoming trauma-competent professionals who are equipped to prevent and manage trauma in their own families and in the organizations where they work.

I hope this research gives us all a greater sense of urgency and a deeper sense of responsibility for doing our part in preventing and reducing childhood adversity. It will be interesting to see how my audience responds to this research. I hope it is more than a thimbleful. Maybe a better analogy is that it takes an acorn to grow a mighty oak.

Invitation for Reflections:

  1. Notice your reaction to the price tag associated with adverse childhood experiences. Are you shocked? Surprised? Angry? Motivated?
  2. What specific things can you do to spread this information to others?
  3. What ideas do you have to use data like this to change attitudes, beliefs and behaviors in your community, state or even at a national level? I encourage you to do whatever you can. Margaret Mead said, “Never believe that a few caring people cannot change the world. For indeed, that is all who ever have.”

Diane Wagenhals, Director, Lakeside Global Institute