Family Trauma Impacts New Mexico’s Economy, and Is Far From Just a “Private Family Problem” Trauma costs New Mexico as it diminished our students' capacity to learn and find employment, as well as impacting our workforce’s productivity.
Adverse Childhood Experiences can lead to substance misuse and mental health challenges that impact learning, work performance and local economies and have long term health impacts that drive up the cost of health care and burden limited health care resources.
The more ACEs endured by an individual, the more likely one is to have emotional, educational and physical challenges – and all these challenges have financial implications for taxpayers.
Adverse Childhood Experiences (ACEs) include the following ten experiences in home environments during important stages of development: physical neglect, emotional neglect, physical abuse, emotional abuse, sexual abuse, and living in households where adults misuse substances, have mental health challenges, are violent to partners, parents are separated, or a family member is incarcerated.
The more ACEs endured by an individual, the more likely one is to have emotional, educational and physical challenges1 – and all these challenges have financial implications for taxpayers who pay for services that address the consequences of trauma.
Traumatized students become a traumatized workforce, impacting the potential for a thriving economy.
While the ACEs survey assess the experiences of an individual, we know that families and communities are composed of those individuals, and the ripple effects impact more than the child who suffers.
The following issues related to ACEs are a starting point for a much broader dialogue within city, county and school board leadership about the costs associated with childhood trauma.
Toxic Stress: Outside of ACEs many children in our communities are experiencing toxic stress. Even without an adverse event or abuse taking place in the home, children are experiencing higher levels of performance expectation and anxiety. The lifelong costs of toxic stress experienced during childhood are enormous, and can manifest in adverse impacts on learning, behavior, and health.2
ACEs and Mental Illness: There is a correlation between ACEs and mental health challenges,3 4 which can impact school achievement and future employment. While there are many factors of mental health and the diagnosis of mental illnesses, including biological factors and genetics, there are specific challenges to mental wellness that be a direct result of ACEs including PTSD, anxiety and depression.
Child Welfare System: ACEs can result in the involvement of child welfare services and their partners in law enforcement and the judicial system, which result in increased trauma when it leads to out of home placement or incarceration all of which result in substantial costs to communities and taxpayers.5 ACEs also contribute to Juvenile Justice involvement,6 incurring further costs and perpetuating cycles of incarceration and trauma.
School Dropout and Underemployment: ACEs can impact students’ capacity to learn, leading to poor academic achievement and high rates of dropout.7 Individuals that are unable to graduate from high school are less likely to have access to job opportunities and experience a higher life time poverty rate than those with high school and college degrees. Individuals that are unable to establish income during years of peak performance are unable to pay into the long-term systems of care and support for later in life including social security and retirement. Cycles of poverty and generational economic stress the increasing cost of care for impoverished seniors. While there is no direct link between dropping out and prison, for dropouts between the ages of 16 and 25, incarceration rates were 63 times higher than among college graduates.8
Substance Misuse: Those with higher ACEs scores are at risk for substance misuse, leading to injury and illness (with costs related to DWI, hospitalization and substance overdose death). In 2007, prescription opioid misuse and dependence cost New Mexico $890 million.9
Impact on Employers: ACEs can lead to various forms of social challenges and substance use that cost employers, nationally an estimated $225.8 billion each year. The largest indirect cost comes in the form of absenteeism, or missing work, and presenteeism, or working while sick.10
The ACEs Study has been described as “the most important public health study that you never heard of” by health advocates,11 a troubling reality given that one in eight children will experience abuse significant enough to be reported and be substantiated by age 18, and far more adversity will fly under the radar of child protective services, law enforcement, the public schools, and even family members of the child experiencing abuse. 12 Our classrooms, from kindergarten through higher education, are filled with students enduring various forms of abuse and neglect and we have an ethical and financial incentive to end this costly epidemic. To that end, we are guided by the research article A Critical Assessment of the Adverse Childhood Experiences Study at 20 years. 13 The author’s insightful writing calls for prevention strategies informed by an understanding of social inequalities, the social determinants of health14 and widening efforts to include social policy.
A CALL TO ACTION
Our Institute’s programming is following the article’s call for new data-driven and cross-sector prevention strategies. We ask that that leaders from the public and private sector join our efforts to reduce all forms of childhood trauma and the associated financial burden15 placed on taxpayers and businesses.
- The Adverse Childhood Experiences (ACE) Study. Felitti et al.1998. www.ncbi.nlm.nih.gov/pubmed/9635069
- The Lifelong Effects of Early Childhood Adversity and Toxic Stress. Shonkoff, et al. 2012. http://pediatrics.aappublications.org/content/129/1/e232
- ACEs and the risk of depressive disorders in adulthood. Chapman, et all. 2004 https://pdfs.semanticscholar.org/c8f5/4111f295a998ad4d39f6ad709785bbbca33a.pdf
- The relationship between ACEs and mental health in adulthood. De Venter, et al. 2013. www.ncbi.nlm.nih.gov/pubmed/23595840
- The economic burden of child maltreatment in the US and implications for prevention. Fang, et al. 2011. https://www.sciencedirect.com/science/article/pii/S0145213411003140
- The prevalence of adverse childhood experiences (ACE) in the lives of juvenile offenders. Baglivio, et al. 2014.
- How childhood experiences contribute to the education-health link, Shanta R. Dube, The Conversation, February 2018. https://theconversation.com/how-childhood-experiences-contribute-to-the-education-health-link-89069
- The Consequences of Dropping Out of High School. Sum, et al. Center for Labor Market Studies, Northeastern University. 2009. https://repository.library.northeastern.edu/downloads/neu:376324?datastream_id=content
- IBIS, NM Dept of Health, Rio Arriba County Drug Overdose Death Rates. (retrieved 13, May 2019) https://ibis.health.state.nm.us/community/highlight/profile/DrugOverdoseDth.Cnty/GeoCnty/39.htm
- Relationship between ACEs and unemployment among adults from five U.S. states. Liu, et al. 2012. Retrieved from the US National Library of Medicine National Institutes of Health. https://www.ncbi.nlm.nih.gov/pubmed/22869349
- The Adverse Childhood Experiences Study – the largest, most important public health study you never heard of – began in an obesity clinic. Jane Ellen Stevens, ACES Too High News, October 3, 2012. https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/
- The Prevalence of Confirmed Maltreatment among US Children, 2004-20011. Christopher Wildeman, PhD; Natalia Emanuel, BA; John M. Leventhal, MD; et al. JAMA Pediatr. 2014;168(8):706-713. https://www.ncbi.nlm.nih.gov/pubmed/24887073
- Research Article: A Critical Assessment of the Adverse Childhood Experiences Study at 20 years by Craig A. McEwen, PhD and Scout F. Gregerson, American Journal of Preventive Medicine, 2019. https://www.acesconnection.com/blog/a-critical-assessment-of-the-adverse-childhood-experiences-study-at-20-years-sciencedirect-com
- Social Determinants of Health, Office of Disease Prevention and Health Promotion. Healthy People 2020. (site accessed May 12, 2019.) https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
- Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis (site accessed September 17, 2019) https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30145-8/fulltext