Understanding Trauma-Informed Care and ACEs

Introduction to Trauma-Informed Care

Dr. Cruz emphasizes the importance of looking beyond the surface when assessing patients.

Early career observations:

• Patients often had multiple health issues and frequently visited emergency departments.
• Common problem: Patients did not improve despite visits.

Understanding Adverse Childhood Experiences (ACEs)

Definition: ACEs include various forms of trauma such as emotional, sexual, or physical abuse, violence, neglect, discrimination, and poverty.

Prevalence in the U.S.:

• 60% of U.S. adults have experienced at least one ACE.
• 25% have three or more ACEs.
• 16% have four or more ACEs.

Demographics:

• ACEs affect all socio-economic groups but are more prevalent in low-income and minority populations.

Impact of Trauma on Health

For young children, repeated exposure to trauma can negatively affect brain development and stress response:

• Can lead to difficulties in emotional regulation as adults, including anxiety, depression, and substance use disorders.
• Increased risk for chronic diseases and behavioral health issues.
• Elevated risk of suicide among trauma survivors.

Changing the Approach to Patient Care

Shift from asking "What's wrong with you?" to "What happened to you?"

Recognizing life experiences as a root cause of poor health is key to improving patient care.

Trauma-informed care focuses on understanding a patient’s history and current needs.

Five Key Strategies for Integrating Trauma-Informed Care