Abstract

Connecting adverse childhood experiences and community health to promote health equity: An integrated model

Ramona Danielson, PhD, MS and Divya Saxena, MS
North Dakota State University, Fargo, ND

APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)

Background: Adverse childhood experiences (ACEs) research has shown that childhood experiences can have wide-reaching effects into adulthood, with strong associations ranging from heart disease to suicide and substance use disorders. Preventing and mitigating the effects of ACEs can reduce the burdens of social and health problems at the population level.

Methods: A conceptual model was created that integrates literature related to ACEs research; the socio-ecological model; social determinants of health concepts; the lifespan perspective; trauma-informed perspectives; and a policy, systems, and environmental change framework.

Results: Increasingly, community health advocates have been working to contextualize the ACEs lifespan trajectory by including additional factors such as historical trauma, institutional racism, and community-related stressors. The Integrated Model for Promoting Health Equity makes community health the focal point for viable prevention and treatment options to address ACEs and promote health equity. Self-healing on a community level is characterized by collective engagement, in which people most affected by ACEs come together to develop strategies that foster individual and community resilience. Further, the use of community health research and evaluation methods that are consistent with trauma-informed, empowerment approaches can also contribute to community self-healing.

Conclusions: The model demonstrates that people are impacted by nested spheres of influence and also have different levels of the socio-ecological model from which they can draw resiliency. The Integrated Model for Promoting Health Equity provides a common language around critical concepts that can help address the link between ACEs and community health as a means to promote health equity.

Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Implementation of health education strategies, interventions and programs Public health or related education Systems thinking models (conceptual and theoretical models), applications related to public health