ACEs IN OKLAHOMA. Oklahoma State Department of Health September 2017
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1 ACEs IN OKLAHOMA Oklahoma State Department of Health September 2017
2 ACEs in Oklahoma 2014 Behavioral Risk Factor Surveillance System (BRFSS) Survey Data 16.2% 21.6% 40.4% 0 ACE events 1 ACE event 2-3 ACE events 4 or more ACE events 21.8%
3 ACEs in Oklahoma 2014 BRFSS Survey Data Male Female Number of ACEs Experianced By Adults, Oklahoma 2014 Percent of Adult Population White NH Black NH AI/AN NH Hispanic < HS HS Some College College Grad <15k 15-25K 25-35K 35-50K >50K ACE event 2-3 ACE events 4 or more ACE events
4 ACEs in Oklahoma 2014 BRFSS Survey Data Prevelance of ACEs Reported by Adults Residing in Oklahoma 2014 Any Abuse 34.3 Physical Abuse 15.8 Repeated Verbal/Emotional Abuse 27.1 Sexual Abuse 11.8 Mental Illness in Household 19.8 Problem Drinker in Household 25.0 Illicit Drug Use in Household 13.5 Incarcerated Household Member 9.3 Parents Seperated/Divorced 32.7 Violence Between Adults
5 ACEs in Oklahoma 2014 BRFSS Survey Data Prevalence of 4 or more ACEs Among Respondents with Specific Experiences, Oklahoma 2014 Physical Abuse (More than once) 72.2 Verbal/Emotional Abuse (More than Once) 54.0 Sexual Abuse (touched more than once) Sexual Abuse (forced to touch more than once) Sexual Abuse (sex more than once) 77.2 Mental Illness in Household 55.8 Problem Drinker in Household 47.8 Illicit Drug Use in Household Incarcerated Household Member Parents Seperated/Divorced 36.7 Violence Between Adults
6 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 40 Adult Current Smokers by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events
7 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 20 Risk Behaviors by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events Heavy (Chronic) Drinker Binge Drank Past 30 Days Rx Drug without Rx
8 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 50 Obese Adults by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events
9 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 14 Adults Ever Diaganosed with Selected Conditions by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events EVER HAVE KIDNEY DISEASE EVER HAVE COPD / EMPHYSEMA / CHRONIC BRONCHITIS ASTHMA
10 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 35 Difficulties with Daily Tasks by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events DIFFICULTY DRESSING OR BATHING DIFFICULTY DOING ERRANDS ALONE SERIOUS DIFFICULTY WALKING OR CLIMBING STAIRS SERIOUS DIFFICULTY CONCENTRATING / REMEMBERING / MAKING DECISIONS
11 Percent of Population ACEs in Oklahoma 2014 BRFSS Survey Data 60 Sleep fewer than 7 hours per day by Number of ACEs Reported, Oklahoma ACE events 1 ACE event 2-3 ACE events 4 or more ACE events
12 Outcome Health Care Information, Center for Health Statistics, Oklahoma State Department of Health. Oklahoma Behavioral Risk Factor Surveillance System, 2014 and Percentage of Adults with Select Poor Outcomes by Number of Adverse Childhood Experiences (ACEs) Fair or poor health Asthma diagnosis ever COPD/emphysema/bronchitis diagnosis ever Arthritis diagnosis ever Depressive disorder ever Could not afford doctor visit in past 12 months due to cost ACEs 4 or more ACEs Percent
13 Behavior Health Care Information, Center for Health Statistics, Oklahoma State Department of Health. Oklahoma Behavioral Risk Factor Surveillance System, 2014 and Percentage of Adults Who Engaged in Select Behaviors by Number of Adverse Childhood Experiences (ACEs) Do not have a regular doctor No medical checkup-up within the past 2 years No dental visit in past 12 months Insufficient sleep on average Current smoker ACEs 4 or more ACEs Percent
14 Reducing ACEs To paraphrase Dr. Robert Anda: What is predictable is often preventable.
15 Framework: Socio-ecological Model
16 While some stress is normal and can have a positive effect, severe chronic stress is toxic Learn more: Center on the Developing Child ard.edu/ Positive Stress Moderate and brief. When a young child is protected by supportive relationships with adults, she learns to cope with everyday challenges and her stress response returns to baseline. Example: sports Tolerable Stress Occurs when more serious difficulties, such as the loss of a loved one, a natural disaster, or frightening injury, are buffered by caring adults. Example: death of a relative Toxic Stress When strong, frequent or prolonged adverse experiences such as extreme poverty or repeated abuse are experienced without adult support, stress can be said to be toxic.
17 What Happens in Early Childhood Can Matter for a Lifetime Early experiences influence the developing brain During early sensitive periods of development, the brain s circuity is most open to the influence of external experiences, for better or for worse.
18 Strengthening Families: Five Protective Factors Parental Resilience Social Connections Knowledge of Parenting and Child Development Concrete Support in Times of Need Social and Emotional Competence of Children
19 Oklahoma s Current Family Support Programs Prevention Focused Universal Education Family Resource Centers Home Visiting Center-Based Individual Intervention Center-Based Group Intervention Open Ended and Time Limited Policy and Law
20 Universal Education Reach Out and Read
21 Family Resource Centers
22 Home Visiting Nurse-Family Partnership (Children First) Parents as Teachers SafeCare SoonerStart
23 Center-Based Individual Servics Audiology Speech Pathology Behavioral Health Physical and Occupational Therapies
24 Center-Based Group Interventions Circle of Parents Circle of Security Incredible Years
25 Policy and Law
26 Lemonade for Life Funded by the MIECHV Innovation Grant Partnership between OSDH University of Kansas Center on Public Partnerships and Research University of Oklahoma Center on Child Abuse and Neglect The Cherokee Nation
27 Lemonade for Life Goal: To improve engagement between Client and Home Visitor and therefore, retain Clients for longer periods of time Note: L4L is just one of several Continuous Quality Improvement Strategies being researched by OU
28 Lemonade for Life Have trained home visitors working within Oklahoma and Tulsa Counties Will directly address ACEs with Clients during a minimum of five visits
29 Lemonade for Life: Pt. 1 Brain Development LESSON ONE: What Every Parent and Caregiver Needs to Know About Brain Development 1) Babies need help making connections 2) Babies need their caregivers to be available 3) Babies brains develop from the bottom up 4) Babies need positive experiences 5) Babies need to feel safe 6) Brains are not fully developed until mid-to-late thirties
30 Lemonade for Life: Pt. 1 Brain Development LESSON TWO: Positive Parenting Builds Healthy Brains 1) Model good behavior 2) Discipline should match your child s needs and developmental level 3) Never use physical punishment 4) Be consistent 5) Talk and explain 6) Take care of yourself
31 Lemonade for Life: Pt. 1 Brain Development LESSON THREE: Trauma and the Potential for Healing 1) Surviving or thriving? 2) Trauma interferes with learning 3) PTSD hurts the brain 4) Trauma leads to other health problems 5) You can make a difference 6) It s never too late
32 Lemonade for Life Pt. 2 ACE Questionnaire 1) Provide the ACE Questionnaire 2) Respond appropriately 3) Provide resources
33 Lemonade for Life Pt. 3 Building Resilience and Hope Hope Ambassadors
34 Lemonade for Life Pt. 3 Building Resilience and Hope Hope Map
35 Lemonade for Life Care of Home Visitors Reflecting on their ACEs Special prompts for Supervisors Secondary Trauma Compassion Fatigue Burnout Self-care
36 Next Steps in Prevention New State Plan for years Request for Proposals regarding Family Resource Centers
37 Special Thanks Derek Pate and Charmel Holland of OSDH for ACE data All our MIECHV Innovation partners Tiffany Holmes for Power Point For more information, please contact : Annette Wisk Jacobi Annettej@health.ok.gov (405)
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