Abstract
Recognition that economic, environmental, and social adversity affects health is not new; adversity may result from social determinants such as poverty, community violence, or poor nutrition; from within the family/caregiving environment; or interactions between these complex environs. However, compelling new research demonstrating the profound impact of cumulative early adversity and toxic stress on development and adult health is leading to the mobilization of global prevention and intervention efforts to attain and assure better health for populations across the world. In this paper, we begin with a global population perspective on adversity and discuss priorities for global health. We then turn to studies of adverse childhood experiences to consider current understanding of how early experiences impact brain development and short- and long-term health. Factors that build resilience and buffer the effects of toxic stress and adversity are described, with emphasis on the foundationally protective role of safe and nurturing caregiving relationships. We discuss the implications of these findings in terms of community health and present a participatory research paradigm as a relationship-based method to improve community engagement in identifying and mitigating the impact of adverse childhood experiences on health.
Highlights
Recognition of how socioeconomic, environmental and psychosocial conditions impact health is generating new avenues for addressing global chronic health conditions, health disparities and inequities, and increasing knowledge of factors associated with positive health
The expanded framework of the SDG’s includes two specific populations at an increased risk of poor health outcomes associated with social determinants of health—children exposed to violence and migrants [1]
Children who experienced three or more Adverse Childhood Experiences (ACEs) were more likely to have below average language and literacy skills and math skills, poor emergent literacy skills, attention problems, social problems, and aggression
Summary
Recognition of how socioeconomic, environmental and psychosocial conditions impact health is generating new avenues for addressing global chronic health conditions, health disparities and inequities, and increasing knowledge of factors associated with positive health. We use a global population health lens to consider the impact of early adversity on short- and long-term health and development, and discuss how protective factors, especially stable, safe, and nurturing caregiving relationships, can buffer the impact of adversity. We discuss the implications of these findings in terms of community health and highlight the community-based participatory research paradigm as one way to improve community engagement in identifying and addressing social and environmental factors that impact health and mental health
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