Tagged With "Structural Racism"
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Parenting Matters: Supporting Parents of Children Ages 0-8 (The National Academies Press 2016)
A study published by The National Academies of Sciences in 2016 resulting in 10 Recommendations to build support for parents... "Over the past several decades, researchers have identified parenting- related knowledge, attitudes, and practices that are associated with improved developmental outcomes for children and around which parenting- related programs, policies, and messaging initiatives can be designed. However, consensus is lacking on the elements of parenting that are most important...
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Physician Perspectives: Examining the Intersections of White Privilege and Racism in Medicine [medicalbag.com]
Two powerful articles published in the Annals of Family Medicine examined the issue of white privilege within the medical community. In the first piece, 1 author Max J. Romano, MD, MPH, from the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, opens with an anecdote of an experience during work at a hospital, when he witnessed other staff members making generalizations about a recently deceased patient based on that patient's race: "One hospital staff member removed a...
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Psychology Needs New Concepts and Healing Models for Racial Trauma [madinamerica.com]
The American Psychologist journal published a new special issue that features the latest psychological research on racial trauma. Feminist psychologist and clinical practitioner, Dr. Lillian Comas-Díaz and her colleagues, introduced the special issue and its mission to foreground novel conceptual models of racial trauma, promote healing on individual and collective levels, and highlight consideration of historical racial injuries. The special issue provides a contemporary examination of...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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Beyond Trauma: Building Resilience to ACEs (brochure)
Wish you had a fairly easy and short way to share all about ACEs? Wish it was in-depth enough to share with teachers, doctors, nurses and therapists but not so long or jargony it puts family and friends to sleep? Here's the perfect thing to share when you've been all up in the faces with ACEs and want to back up your words before, during or after. This brochure is comprehensive but not so long that it remains in the "I'll get to it later," pile. Please feel free to print, forward, download...
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Boston’s architect of community well-being: Pediatrician Renée Boynton-Jarrett
She talks with parents about the relationship between childhood adversities they have experienced and how that may have an impact on parenting.
“I frame things a bit more broadly than ACEs,” she said, “because I think it’s very important to reflect on a broader number of exposures than were covered in the original study, such as poverty or structural violence and racism.”
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Building a Movement to Birth a More Just and Loving World [Groundswell March 2018]
The National Perinatal Task Force: Building a Movement to Birth a More Just and Loving World - In my 20 years as a public health nurse, I've never seen race called out so clearly in a report like this. Data has shown disparities, however the data was presented in a tidy way — very apolitical, purposely written to not ruffle any feathers or point fingers - " persistent racial gap ". This report written by The National Perinatal Task Force is refreshingly honest and this is important. We need...
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Building trust is now a critical part of health care
In a video clip , a hospital patient turns away in protest as a physician enters the room. “Why do you all keep coming in my room!” she asks in frustration. The physician moves a chair out of the way and sits down at eye level with the patient. “You’ve had to see so many people,” he acknowledges. “And I’m tired of it!” she yells. “I already know I have to get both of my legs cut off. That’s what they keep saying. I don’t have a choice!” “You don’t feel like you have a choice,” he repeats...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
[Editor's note: This blog was first posted in April 2017. Dr. Marie-Mitchell updated the assessment by modifying a few of the questions, so we are republishing with the new assessment, one in Spanish and one in English.] Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents...
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CA to reimburse for only one of three ACEs screeners
California health care providers will soon begin to learn how many of the 13.2 million California children and adults in the state’s MediCal program have been exposed to adverse childhood experiences (ACEs). But the state’s proposed decision to reimburse only one of three recommended options for screening children has drawn mixed reactions from pediatricians. “If we have mandated legislation that only looks at one screening tool, it really limits the opportunity to improve that screening...
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California healthcare providers adapt ACEs screening from in-person to virtual environment
Dr. Amy Shekarchi, a pediatrician based in Los Angeles, CA, was helping to lead the rollout of ACEs screening among 50 health care providers at six clinics affiliated with the L.A. County Department of Health Services when the COVID-19 pandemic hit—days before she was set to launch the effort. “We had trained everybody in doing face-to-face [ACEs screening], and when COVID-19 happened we thought, let’s not throw the screening out. Everybody was ready,” says Shekarchi, who is the pediatric...
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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025
In 2017, Dr. Audrey Stillerman and three other women from the Chicago healthcare community founded the THEN Center . Its goal is lofty: By 2025, it wants every graduating student in medical and health sciences across the United States to apply core concepts of childhood adversity, neurobiology, resilience and health equity into their work. Dr. Audrey Stillerman Today, the THEN Center (The Collaborative Study of Trauma, Health Equity and Neurobiology) is well on its way. Its founders are...
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Chronic Stress Exposure Among Young African American Children with Asthma: Racism is a Factor [annallergy.org]
By Bridgette L. Jones, Vincent Staggs, and Brianna Woods-Jaeger, Annals of Allergy, Asthma & Immunology, September 17, 2019 African American and Hispanic children are more likely to have a diagnosis of asthma and significantly higher disease related morbidity in comparison to non-Hispanic white children. Mortality rates are likewise higher as African American children are 8 times more likely than non-Hispanic white children to die from asthma 1. The cause of this striking health...
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Commentary: Pediatricians called to address racism, intolerance to achieve health equity [AAPPublications.org]
As pediatricians, we champion the need to address social determinants of health, such as poverty and food insecurity, in an effort to achieve health equity. We emphasize screening for toxic stress. In our conversations about equity, we include data about racial and ethnic disparities. Because of our commitment to work for the health and well-being of all children, pediatricians are uniquely positioned to consider and address the needs and concerns of the at-risk communities for whom we care.
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Introducing NEW Becoming Trauma-Informed & Beyond Community
Earlier this year @Dawn Daum wrote to us when she was ready to share ACEs science with people in the organization she works in to make a case for moving towards more trauma-informed care for the benefit of the staff and those they serve. She was frustrated because almost all the training and resources she found were geared towards schools, clinical staff or to organizations working with children and families rather than ACE-impacted adults in the workplace and who are...
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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults
In July, medical residents in family medicine at Kaiser Permanente in San Jose, CA, began screening adult patients for adverse childhood experiences (ACEs). But it’s an ACE survey with a twist: it’s shorter, not the 10-question survey of the original CDC-Kaiser Permanente ACE Study , according to Dr. Kathryn Ridout who is leading the pilot along with Dr. Francis Chu and Dr. Alec Uy . Why a shorter ACE survey? Dr. Kathryn Ridout “When we were doing our initial discussions with stakeholders in...
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Montefiore Medical in Bronx screens 12,000+ kids for ACEs
Creative Commons/Flickr/Family drawing by Meggy ____________________________________ Since 2016, more than 12,000 children beginning at the age of 1-years-old have been screened for adverse childhood experiences (ACEs) at Montefiore Medical Center in Bronx, New York, according to Miguelina German, the director of Quality & Research in the Pediatric Behavioral Health Integration Program and project director of Trauma Informed Care at the center. Parents of infants are asked to fill out...
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National collaborative provides roadmap for doctors to ask about adult patients' ACEs, current trauma
How do you ask patients about current and past trauma? And how do you respond to their disclosures? Those are two key questions that members of a national collaborative who are among the early adopters of trauma-informed care practices have answered in a recent article in the journal Women’s Health Issues. Dr. Edward Machtinger To Dr. Edward Machtinger, the lead author of the paper entitled, “ From treatment to Healing: Inquiry and response to recent and past trauma in adult health care” ,...
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New organization calls all pediatricians to end crisis that's "hiding in plain sight"
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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New survey paints dire picture of challenges black moms face in health care system [centerforhealthjournalism.org]
A new California survey of pregnant and new mothers paints a bleak picture of what it’s like to be a black mother. In Listening to Mothers in California, black mothers reported not being heard by their health providers and said they experienced discrimination during childbirth. They also experienced higher rates of anxiety and depression during and after pregnancy than white women. The findings add fuel to a growing sense of urgency on maternal health. On Wednesday, California Gov. Brown...
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Next "A Better Normal" community discussion series: April 3, 2020/ Maternal health and pediatrics in the time of COVID-19
Steve Sack • Star Tribune The "Better Normal" community discussion for Friday, April 3, 2020, features two wonderful staff members from ACEs Connection: Karen Clemmer, community facilitator for the Northwest, Far Northern California, Alaska and Hawaii; and reporter Laurie Udesky, who is also community manager for the ACEs in Pediatrics community on ACEsConnection.com. Karen Clemmer Join them at noon PT/ 1 pm MT/ 2 pm CT/ 3 pm ET and share your thoughts, ideas, questions, concerns, and...
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NJ medical school program requires all first-year students to learn about ACEs science
In 2015, Dr. Beth Pletcher, a pediatrician and associate professor specializing in genetics, was at the annual conference of the American Academy of Pediatrics in Washington D.C. when she heard two speakers that forever changed her work with medical students. Dr. Beth Pletcher “I went to two talks on adverse childhood experiences (ACEs) that were so mind-boggling to me that I decided on my drive back to New Jersey that I had to do something about it,”says Pletcher, director of the Division...
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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]
By Bob Erlenbusch and Drew Factor, California Health Report, November 20, 2019 “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying. According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common,...
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Parent Handouts: Understanding ACEs, Parenting to Prevent & Heal ACEs (English)
Please see the main post for these parent handouts in the ACEs Connection Resources Center. These two flyers ( Understanding ACEs and Parenting to Prevent & Heal ACEs ) can be downloaded, distributed, and used freely. One is brand new and the other is a revision. Both flyers were made with generous support from Family Hui, a Program of Lead for Tomorrow. Translations of these flyers are in progress and will be shared by Family Hui and updated on ACEs Connection when available.
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Documentary Broken Places uses archival footage to tell stories of ACEs and resilience over time
Why do children exposed to the same level of adversity in childhood have different outcomes? Why do some thrive and others become completely damaged? These were the kinds of burning questions that prompted filmmaker Roger Weisberg to produce the documentary Broken Places , which was shown in a private screening at the 2018 National ACEs Conference in San Francisco. The film delves into the adverse childhood experiences (ACEs) that each of the adults profiled in it endured first as children.
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Dozens of Kaiser Permanente pediatricians in Northern California screen three-year-olds for ACEs
Since August 2016, more than 300 three-year-olds who visited Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the...
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Dr. Nadine Burke Harris Presents at SCVMC-Pediatric Grand Rounds
Dr. Nadine Burke Harris presented today at Santa Clara Valley Medical Center during Pediatric Grand Rounds to a full room (standing room only) of pediatricians, nurse practitioners, physicians assistants, public health professionals and allied medical staff. With the show of hands, many of us in the room were familiar with ACEs science and the health impacts of toxic stress. With ease, Dr. Burke Harris dove into great detail of our bodies response to toxic stress and the multitude of...
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DULCE helps pediatricians in Oakland, CA, prevent toxic stress in newborns
On a recent day in early March, Laura Lopez met a former patient of hers in the waiting room of Highland Hospital’s pediatric clinic in Oakland, CA. The patient had forgotten her Medi-Cal card and called Lopez asking for help. But in the brief conversation, Lopez, a family specialist with the DULCE program, learned about some dire changes in the patient’s life. Laura Lopez “Without me even asking, she shared with me that she had separated from her partner, that she needs to apply for food...
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First health-related cost of ACEs study shows $113 billion price tag for California; just one ACE costs $28 billion
Researchers who have been looking for a way to quantify the health toll of ACEs in dollar terms, now have an example in a newly-released study of California. ACEs exacted a toll costing an estimated $113 billion annually, according to the study in the journal PLOS One that was commissioned by the Center for Youth Wellness. ACEs-associated cardiovascular disease was the condition that lead author Ted Miller dubbed “the giant in the room.” It accounted for $29.6 billion in spending, more than...
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For a pediatrician and former teacher ACEs awareness came from a punch in the face
Dr. Kavitha Selvaraj did not learn about adverse childhood experiences (ACEs) from a class in medical school. Her first awareness of ACEs came after a student slugged her in the face when she was a new teacher in a school in Los Angeles. She had heard a chorus in the hallway urging her students she refers to as “J” and “N” to “Fight! Fight! Fight,” she writes in an essay in a recent issue of the journal Pediatrics . The two were trading punches. When she stepped in the middle to break it up...
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Graduations, non-linear paths, & the importance of getting started
With graduation season upon us, I have been thinking a lot about one of my favorite graduation speeches. It’s the speech that Shonda Rhimes, creator of Grey’s Anatomy, gave in 2014 at Dartmouth College. She references the typical expected advice from a graduation speech: “Follow your dreams. Listen to your spirit. Change the world. Make your mark. Find your inner voice and make it sing. Embrace failure. Dream. Dream and dream big..." And then she says, “I think that’s crap.”
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Heyman Oo integrates ACEs science as foundation of pediatric care
Dr. Heyman Oo, a 34-year-old primary care pediatrician, first learned about the science of adverse childhood experiences in medical school at a grand rounds held around 2012 at Rady Children’s Hospital in San Diego, which she attended from 2009 to 2014. The presenter was none other than Dr. Nadine Burke Harris, a pediatrician who went on to become California’s first Surgeon General. The founder and former director of the Center for Youth Wellness drew millions of views for her TED talk on...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children
Dr. Elizabeth Grady is a pediatrician at the South San Francisco Clinic, a community clinic of San Mateo Medical Center. She and Susana Flores , a senior public health nurse with San Mateo County Health, spoke with me about how the clinic and other health agencies in San Mateo have been able to craft ways to work together to prevent and heal toxic stress in children. Grady also talked about how she and Flores have been working with the Resilient Beginnings Collaborative (RBC), a group of...
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How do these pediatricians do ACEs screening? Early adopters tell all.
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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I’m Sick of Asking Children to Be Resilient [nytimes.com]
FLINT, Mich. — A baby born in Flint, Mich., where I am a pediatrician, is likely to live almost 20 fewer years than a child born elsewhere in the same county. She’s a baby like any other, with wide eyes, a growing brain and a vast, bottomless innocence — too innocent to understand the injustices that without her knowing or choosing have put her at risk. Some of the babies I care for have the bad luck to be born into neighborhoods where life expectancy is just over 64 years. Only a few miles...
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In ACEs Connection webinar, physicians talk trauma, offer tips for helping pediatric immigrant patients
Dr. Raul Gutierrez, a pediatrician in the San Francisco Bay Area, said he and his fellow clinicians see constant fear and its health consequences every single day among the largely immigrant and Latino population they serve. It’s all the result of anti-immigrant policies and the news cycle that feeds the fear. Dr. Raul Gutierrez “It is almost inescapable with the repercussions of immigration policy on the radio, television, social media and from friends and family,” Gutierrez told the 69...
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4 years after integrating ACEs science, Pueblo, CO clinic improves services for families; cuts ER costs, doctor stress
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it
Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago. She’s seen it as the regional child abuse services and champion for the Permanente Medical Group. And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children...
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AAP Announces New Initiative to Confront Violence in Children's Lives [AAP.org]
The American Academy of Pediatrics (AAP) today announces a new initiative in the wake of the recent killings of two black men in St. Paul, Minn., and Baton Rouge, La., and of five police officers in Dallas. The AAP will convene a group of pediatrician experts to identify new approaches to protect children, adolescents and young adults from the epidemic of violence occurring in their everyday lives. The initiative's members, agenda and goals will be shared in the coming days, and will address...
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ACEs & African Americans Community on ACEs Connection
ACEs Connection envisions a resilient world where ALL people thrive. We are an anti-racist organization committed to the pursuit of social justice. In our work to promote resilience and prevent and mitigate ACEs, we intentionally embrace and uplift people who have historically not had a seat at the table. ACEs Connection celebrates the voices and tells the stories of people who have been barred from decision-making and who have shouldered the burden of systemic and economic oppression as the...
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ACEs Research Corner — October 2019
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! — Jane Stevens] Zhang L, Zhang D, Sun Y. Adverse Childhood Experiences and Early Pubertal Timing Among Girls: A Meta-Analysis. Int J Environ Res Public Health. 2019 Aug 13;16(16).
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Adverse Childhood Experiences (ACE) Study: Beyond Screening in Pediatrics
The evidence is clear. When bad things happen to us as young children, we are at significantly increased risk for not only mental health problems, but also a wide range of physical health problems including asthma, heart disease, and even early death. These "bad things" all involve disruptions in caregiving relationships. A national movement directed at screening for ACEs in pediatric practices has emerged from this work. My suggestion that the implication of the Adverse Childhood...
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American Academy of Pediatrics Addresses Racism and Its Health Impact on Children and Teens [aap.org]
By Maria Trent, et. al., American Academy of Pediatrics, July 29, 2019 Racism has a profound impact on children’s health. With the goal of helping all children reach their full potential, the American Academy of Pediatrics (AAP) is publishing new recommendations on ways to lessen the impact of racism on children and teens. In the policy statement, “ Racism and Its Impact on Child and Adolescent Health ,” the AAP calls on pediatricians to create welcoming, culturally competent medical...
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Sharpening the global focus on ethnicity and race in the time of COVID-19 [thelancet.com]
By Neeraj Bhala, Gwnetta Curry, et al., The Lancet, May 8, 2020 Tackling injustices, including those that result from prejudice and racism globally, is essential in the response to the coronavirus disease 2019 (COVID-19) pandemic. Here, we focus on UK South Asian and Black and African-American populations, using internationally recognised terminology and definitions, and consider the UK and the USA as globally relevant examples. We recognise other minorities also need consideration in the...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all
In a house called “Johanna’s House” on a tree-lined side street in Vallejo, Calif., four women are filling out the adverse childhood experiences (ACE) survey given to them by Maria Guevara, the founder of Vallejo Together, an organization that serves homeless residents in Vallejo. The house was named for Johanna Dilag, a homeless woman who was found dead along with her dog.
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Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study; Expert on ACEs Science
Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and...
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Strengths-based Approaches to Screening Families for Health-Related Social Needs in the Healthcare Setting [Center for the Study of Social Policy]
How do you screen families to determine whether they have enough to eat or if they feel safe in their homes or communities without alienating them? In this new brief, authors Dr. Renee Boynton-Jarrett and JoHannah Flacks describe strength-based approaches to screening for health related social needs.