The Next Great American Public Health Campaign? Readers Make Their Picks [nytimes.com]

Carey:  one comment about your comment, re "childcare" -- the problem is "childcare" is now used interchangeably for infants, toddlers, and pre-schoolers.  My quibble is the implication that childcare is a universal plus, because I believe that it is a serious negative for infants.  

ACE-aware people need to be careful of recommending more 'childcare' when *group care in infancy* is itself likely to be an ACE, whereas for three year olds it is entirely different.   I know this is loaded territory, and painful to contemplate in a world where economic reality makes daycare commonplace, but with what we know about neurological development and cortisol, the fact that a baby in daycare has an abnormal rising cortisol pattern that persists to teen years is very worrying.  Early group care is very stressful to small infants.   40% of US kids do not have secure attachment -- the critical task of 0-3 is forming this attachment-- so I believe we need to be judicious about assuming more childcare is better.

One suggestion which would be supported by a lot of the other articles tendered around around the negative manifestations of childhood trauma would be to immediately abolish male child circumcision. 

Yea!  Mothers and Babies are the first priority  and this aligns with what we know about ACEs science and with the author's thesis that public health programs can pay for themselves . 

It makes sense -supporting at-risk pregnant women, prepares them as they transition to becoming a mother - who will care for, bond with, and protect their newborn baby.  Just imagine a newborn that is loved, protected, and in attunement with their primary caregiver.  Powerful protective factors! WOW! 

The "Heckman Curve" has been around for some time - along with his many published reports (one attached) .  In my PH experience, sometimes making a "business case" for public health interventions is better received than promoting earlier intervention based on science, health outcomes data and the reduced burden of chronic disease.  

My favorite quote from article, "Not only have many public health interventions in the United States been hugely successful, but they’ve also saved more money than they’ve cost."    

To realiZe our potential? Stop the BCMT: Baby  Child Mama Trauma. 

Just one generation -- providing childcare, healthcare, a quality education, trauma-free housing, loving support to JUST ONE GENERATION of American children - From WOMB to 21 - would change this nation. In 25 years it would be a much more peaceful place. Just one generation! Imagine.

We must improve the way we nurture small children if we actually want to improve public health. Kaiser’s Adverse Childhood Experiences (ACEs) study by Dr. Vincent Felitti showed us some 20 years ago that adversities in childhood seed both physical and mental illnesses. Kids who experience traumas have more cancer, heart disease, diabetes, depression, suicide and addiction as adults. And there is a dose response effect: The more adversity, the worse the health outcomes.

# 1 on the list is addressing ACEs! And reading the rest of the campaign ideas -- most of them have at their roots ACEs ... if we addressed ACEs we could cut off many of these other PH issues at the knees.  

As a Public Health (PH) practitioner, when i learned about the ACE study about 5 years ago (from our very own Jane Stevens at a local cafe.  I am so lucky to live in the same county as Jane!) I was SHOCKED that i had been working in PH for nearly 20 years and had never heard of the study.  I agree with the NYT reader that addressing child adversity (by raising awareness about ACEs throughout the community) is THE next great PH campaign! But heck Jane called out this gap in public health knowledge in her 2012 article The Adverse Childhood Experiences Study - the largest, most important public health study you never heard of - began in an obesity clinic.