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By Pamela Hartzband, M.D., a nd Jerome Groopman, M.D. June, 25, 2020, N Engl J Med 2020; 382:2485-2487 DOI: 10.1056/NEJMp2003149. Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care system, most prominently the widespread implementation of the electronic health record (EHR) and performance metrics. 1 Initially, the...

Building Resilience with Children During Racial Discrimination & Violence: This attached Resilience Brief for Children has been the hardest one I have written yet. I have been an active advocate for the equal treatment of people from all backgrounds, religions, ethnic heritages, orientations, and families my entire life. It is hard to see the pain present today, not only due to COVID19 but also due to the harm and anger we see daily in the news. I want to share a story about the person...

By ArtNet News, June 29, 2020. As conversations about bias in health care reach new heights amid the COVID-19 pandemic, a new course at the University of Alabama at Birmingham School of Medicine is hoping to combat the scourge with an unlikely tool: famous artworks. The school has launched a new course in collaboration with the university’s Abroms-Engel Institute for Visual Arts and the Birmingham Civil Rights Institute that tasks junior- and senior-level med students with analyzing works of...

"I think that all of us, regardless of our racial or ethnic background, feel relieved that we no longer have to deal with the racism and the sexism associated with the system of slavery. But we treat the history of enslavement like we treat the genocidal colonization of indigenous people in North America, as if it was not that important, or worse, as if it never happened." —Angela Davis, "The Meaning of Freedom" Please join us for the ongoing community discussion of A Better Normal, our...

By Rachel R. Hardeman, Eduardo M. Medina, and Rhea W. Boyd, New England Journal of Medicine, June 10, 2020 In Minnesota, where black Americans account for 6% of the population but 14% of Covid-19 cases and 33% of Covid-19 deaths, George Floyd died at the hands of police. “Please — I can’t breathe.” He was a black man detained on suspicion of forgery, an alleged offense that was never litigated or even charged, but for which he received an extrajudicial death sentence. “Please — I can’t...

Click here for the CMS Corona Virus Waivers & Flexibilities. Coronavirus Waivers & Flexibilities In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. There are different kinds of 1135 waivers, including Medicare blanket waivers. When there's an emergency, sections 1135 or 1812(f) of...

By Hannah M. C. Schreier, Yuliya I. Kuras, [...], and Nicolas Rohleder Abstract Experiences of child maltreatment are associated with a host of adverse mental and physical health outcomes in adulthood. Altered reactivity to psychosocial stress exposure may partially explain known associations between early experiences of maltreatment and later life health. The present study focuses on examining whether experiences of child maltreatment are associated with physiological reactions to initial...

Tamar B Rubinstein et al. J Pediatr . 2020 . Abstract Objectives: To determine whether there is an association between adverse childhood experiences (ACEs) and childhood-onset arthritis, comparing youth with arthritis to both healthy youth and youth with other acquired chronic physical diseases (OCPD); and to examine whether ACEs are associated with disease-related characteristics among children with arthritis. Study design: In a cross-sectional analysis of data from the 2016 National Survey...

Sharing - if funding is in your area, consider seeking opportunities to infuse ACEs science! June 18, 2020, Press Release: Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing awards totaling $107.2 million to 310 recipients to increase the health workforce in rural and underserved communities . Recipients across 45 states and U.S. territories received funding to improve the quality, distribution and...

Hi everyone! We'd like to introduce our new ACEs Connection Anti-Racism Resources List c ulled from resources shared by Learn4Life, Prevention Institute., Rise Magazine , V A TICN , Vital Village , 10% Happier . and our own ACEs Connection members and staff . You can access them from this widget on the top right side of our home page or by clicking here. The list has the following categories of resources: Racial Trauma, Historical Trauma, & Healing Police Brutality & Reform...

Grabbe searched for models that would help her homeless and addicted patients. “There are good body-based models for psychotherapy, which may be the most effective approach for trauma,” she says, “but hardly any of my patients were receiving any kind of therapy. There are thousands of people in our communities who have high ACE scores who will never get the years of psychotherapy they deserve. CRM is a self-mental wellness care tool and is exquisitely trauma-sensitive—so it can help enormously.”

Whether or not to screen for ACEs in primary care is an important debate—and I hear and respect the passion from both sides of the argument. I fall in the “pro-ACE assessments” camp, but with some important caveats. I think that assessments for ACEs are dramatically different from screening for autism or developmental delays. In my opinion, assessments for ACEs in primary care should be primarily about building relationships.