A decade ago, I was introduced to one of the largest studies on the health impacts of childhood adversity. The Centers for Disease Control-Kaiser Permanente Adverse Childhood Experiences (ACE) study was conducted in the late 1990s and identified how traumatic events in childhood could impact health and well-being into adulthood. Research revealed ACEs were common and increased the risks for poor health and public health outcomes.
Initially I felt somewhat powerless in this knowledge. The data made sense. I had observed the unhealthy outcomes. Yet now that we know, what can we do? How do we address ACEs to decrease their impact? Others had similar questions.
As our understanding of the harm caused by ACEs has evolved, so have efforts to build resilience for our children, families and communities. In public health and prevention, we know that increasing protective factors decreases risk factors. The latest research recognizes that ACEs can be prevented. Yet even when they’re not prevented, there is hope in the science of positive experiences.
On its website, the wellness-focused Montana Institute states: “In the early 2000s, a new research question emerged based on the Science of the Positive: What if The Positive in childhood has a lasting protective and healing impact similar to the lasting harmful impact of trauma? The resulting science of health outcomes from positive experiences is ongoing and includes strong evidence that Positive Childhood Experiences (PCEs) have a lifelong protective and healing effect that can mitigate the negative effects of Adverse Childhood Experiences (ACEs)”.
Since a landmark 2017 Medical Foundation study by Sege, Bethell, Linkenbach and others, scientific research on how PCEs impact health has expanded rapidly. The resulting movement, Healthy Outcomes from Positive Experiences (HOPE), embraces the science of positive experiences in childhood and adulthood. Positive experiences can help children and youth grow into more resilient, healthier adults. Positive Adult Experiences (PAE) can affect our health and well-being through closeness and social connection.
This provides hope and healing into adulthood. Research, such as a 2019 JAMA Pediatrics study on PCE, has established that positive experiences at any age can lead to better health outcomes. While it is important to understand the long-term negative consequences of childhood adversity, looking at the effects of PCEs and PAEs provides a more holistic view of the person. It provides hope in our ability to heal and achieve good mental, physical and social health.
The four building blocks of HOPE – relationships, environments, engagement, and emotional growth – are centered on positive experiences. HOPE brings a public health approach to building strong, healthy, and resilient people and communities. These building blocks identify ways our communities and care systems can provide more positive experiences for individuals and support families to nurture and celebrate their unique strengths.
During a recent visit with my daughter, our conversation turned to how much she loved watching “Mr. Roger’s Neighborhood” as a child. This program left a lasting impression on her. The show featured diverse characters and tackled difficult topics. It served as a model for fostering a sense of belonging and inclusion. It encouraged each of us to see the value in ourselves and others. In times of difficulty, Mr. Rogers encouraged viewers to focus on those who are actively working to make things better, offering a message of hope and resilience. As I reflected on this conversation, I drew parallels to Mr. Roger’s Neighborhood and HOPE’s building blocks.
Relationships encourage us to look for opportunities to be helpers in our community. I often turn to the following quote from Maya Angelou when I think about relationships and how they can be building blocks of resiliency:
“I’m not sure if resilience is ever achieved alone. Experience allows us to learn from example. But if we have someone who loves us – I don’t mean indulges us, but who loves us enough to be on our side – then it’s easier to grow resilience, to grow belief in self, to grow self-esteem. And it is self-esteem that allows a person to stand up.”
In her book “The Connection Cure,” author Julia Hotz provides a thoughtful description of the importance of the second building block, environment. “A huge part of health is determined by the environment where we live,” Hotz writes. “To survive we need basic resources – the things you think about when you hear “environment: clean air, nutritious food, shelter and money. To thrive we need sources of joy, meaning, and relationships in our environments, too: reasons to wake up, things that make us feel healthy, and connections to what matters to us. Together these sources of surviving and thriving are social determinants of health.” The American Medical Association attributes 80% of our overall health to our environment and these social determinants of health. When our environment is healthy, our community is healthier and more resilient.
It is a human need to feel loved and connected to our community. Resilience grows when we have a sense of belonging and cultivate an awareness of what matters. This winter I watched the documentary “Live to 100: Secrets of the Blue Zones.” One of my key takeaways was about the significance of strong social connections in our overall health and well-being. The centurions featured in these communities upheld deep relationships within their community. These relationships with family and neighbors provided emotional support, reduced stress, and created a sense of belonging. They immersed themselves in their communities in ways that created a sense of purpose and formed deep connections. Engagement enriches our lives.
My six-year-old grandson provided me with a meaningful example of emotional growth, the final building block. One day, he explained to me how he felt different “spots,” or expressions of emotion, from happiness to anger to loneliness and beyond. He demonstrated a great deal of mindfulness about his feelings and self-regulation. He attends an elementary school that uses the PAX Good Behavior Game to support emotional and social learning. This curriculum and the educators who shared it have given him invaluable tools to build resiliency. Social wellness is as much a part of overall well-being as good nutrition and exercise.
Building a strong, healthy and resilient community holds a significant place in my thoughts. Resiliency offers us the ability to heal and become healthy after experiencing adversity. It allows us the experience of growth and success. Feel free to reach out if you would like to learn more about ACEs, PCEs or resilience.
In the wise words of Mr. Rogers, “Won’t you be my neighbor?”
Pam Hanna is Jefferson County’s Public Health Supervisor. Contact her at phanna@jeffersoncounty-mt.gov.
