Childhood Trauma Costs Alaska’s Workforce Millions
Sources: 2013-2015 Alaska BRFSS, Section of Chronic Disease and Prevention, Alaska Division of Public Health, Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey ACE Module Data, 2010
Alaskans are having an increasingly expansive discussion about childhood trauma and the far-ranging impacts these events have on the economic, health, and social outcomes of individuals as well as the larger issues facing the state. Greater understanding of the biology of trauma is helping expand the understanding of the psychological impact of trauma.
Dr. Christopher Blodgett, PhD is a national expert on childhood trauma and a professor at Washington State University. In November, a group of organizations partnered to host Blodgett for a series of forums in Anchorage, Juneau, and the Mat-Su to highlight the impacts of childhood trauma on schools, communities, and health across the state. Four events were held and all were to full rooms. The forum at the ZJ Loussac library had 140 people in attendance, and more than 60 people watched the live webinar. Blodgett’s expertise was made available through the All Alaska Pediatric Partnership with support from the Alaska Mental Health Board, Advisory Board on Alcoholism and Drug Abuse, Alaska Children’s Trust, and thread, Inc.
Child Trauma in Alaska Is Common
Alaska has high rates of childhood trauma. Using methodologies developed by the Center for Disease Control and Prevention, the Alaska Division of Public Health asked more than ten thousand adults in 2013-2015 if any of the following potentially traumatic events happened to them before their 18th birthday: emotional abuse, sexual abuse, physical abuse, alcohol or drug abuse in the home, witnessing domestic violence, mental illness in the home, parents separated or divorced, or parent or family member were incarcerated.
In a recent report titled “Economic Costs of Adverse Childhood Experiences in Alaska,” released by the Alaska Mental Health Board and Advisory Board on Alcoholism and Drug Abuse, it was estimated that nearly $350 million of current annual adult Medicaid expenses exist because of childhood trauma experienced by Alaskan adults.
Two out of three adults in Alaska endured an Adverse Childhood Experience. Some of those adults lead healthy, productive lives; however, for some Alaskans, those experiences have led to chronic diseases, depression, and addiction. These problems translate directly to challenges to a healthy workforce and cost employers and the state significant amounts of money.
Several reasons exist for these different outcomes. Approximately two out of three Alaskans surveyed answered yes to at least one of the adverse childhood events listed above. While no national rates of ACEs are currently available, the CDC has aggregated data from ten states (Hawaii, Maine, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Vermont, Washington, and the District of Columbia) to create a research sample of fifty-three thousand adults. This sample is currently the best estimate of national rates of ACEs. Alaska’s rates of childhood trauma are higher in every category, as seen in Table 1 above.
What Can Happen to Us if We Are Traumatized as Children?
“There are at least 650 scientific journal articles showing links between ACEs and the increase in likelihood of poor outcomes,” Blodgett told a forum of state leaders, educators, and mental health professionals in Juneau who gathered to discuss the topic of trauma-informed schools. He went on to say “This is well established science. Toxic” levels of stress hormones released by prolonged exposure to childhood traumas have been linked to changes in the structure—and therefore function—of the developing brains of children and youth. These changes hamper the ability of a child to learn and develop normally unless addressed effectively in multiple settings. These brain changes can, if not addressed, lead to costly outcomes in later life.”
The “costly outcomes” Blodgett named include:
LOWER SOCIO-ECONOMIC STATUS
- Lower income
- Less homeownership
- Lower levels of educational achievement
- Being unable to work
- Work absenteeism
- Heart disease
- Illegal drug use
- Suicide attempts
What Can Be Done?
Understanding ACEs and their impacts on brain development is foundational to moving institutions toward more cost effective practices. Recent meetings with Blodgett also included discussion of specific changes to how we deliver education, healthcare, and community services to better support resiliency and recovery from trauma. In Juneau, Blodgett described how the Collaborative Learning for Educational Achievement and Resilience (CLEAR), an evidence-based trauma-informed schools model, has increased reading scores by 12 percent compared to schools not using this relatively low cost intervention. The CLEAR approach provides educators and other school staff training and tools to help children and youth get back on track, without extended periods out of instructional time. Increases in instruction time and improved educational achievement are clear goals central to schools’ missions. Blodgett said, “If we can’t show an improvement to your core mission of educating children, we don’t want to waste your time.” CLEAR is a relatively low-cost intervention, especially considering the millions childhood trauma costs Alaska every year. Communities can partner with CLEAR for three years, at a cost of $40,000 per year, to embed trauma-informed practices in a school.
Trauma-informed schools are not an entirely new concept in Alaska. Seeing the impact of trauma on students and schools, some school districts and individual principals have begun to address the consequences of ACEs in the classroom. Josh Arvidson, founder and director of the Alaska Child Trauma Center at Anchorage Community Mental Health Services, is a nationally recognized expert in childhood trauma. He echoes Blodgett’s message, describing how chronic stress turns a “learning brain into a surviving brain.” Arvidson explained to educators and counselors gathered in Juneau that children treated at the Alaska Child Trauma Center can and do heal from traumatic events with help from supportive adults. They get out of the state of fight, flight, or freeze (stress reaction) and are able to get back on track.
Both Arvidson and Blodgett employ the ARC Framework (attachment, self-regulation, and competency) to help children and youth rebuild attachment to trusted adults, build skills to stay calm and focused when stressed, and feel a sense of mastery and competency of their lives. This model was developed by Bessel Van der Kolk, arguably the premier trauma expert in the world, to help people (re)build core skills needed to navigate traumatic experiences. The outcomes possible through the use of this framework have a significant relationship to economic success.
In Juneau, Kate Burkhart, executive director of the Alaska Mental Health Board and Advisory Board on Alcoholism and Drug Abuse, commented that Alaskan employers “want workers who can get along with coworkers, stay calm and focused when faced with difficult situations, and be effective and competent in their jobs.” She continued, “What Dr. Blodgett and Mr. Arvidson discussed today is how we can very intentionally support development of those skills while kids are still in school.”
James Heckman, Ph.D., a Nobel Laureate in Economics from the University of Chicago, often writes about the economic effects of trauma in his blog titled Heckman Equation. He notes that adults who are successful have “soft skills” or “character skills” that allow them to function at high levels. These skills are often as important if not more important than a person’s IQ. Heckman says, “this sounds very touchy-feely, but it’s not … we have a growing body of evidence that shows that these factors matter.” Heckman promotes early childhood programs for children exposed to hardships to help foster skills needed to succeed at school and later in the workplace. His research demonstrates the clear economic benefits of doing this when people are young. While change can happen at any age—it is more cost effective to instill these skills early.
Alaskans experience childhood trauma at very high rates, which means that we see the impacts of that trauma in schools, workplaces, healthcare practices, and communities. Impaired academic success, chronic disease, addiction, and lost productivity at work all have economic consequences. Working together to embed trauma-informed interventions where they can be most effective—the classroom, the pediatrician’s office, the shop floor—can reduce the costs we pay every day.
Pat Sidmore is an H&SS Planner for the Alaska Department of Health and Social Services Alaska Mental Health Board. Contact him at 907-465-3072 or firstname.lastname@example.org.
This article first appeared in the December 2016 print edition of Alaska Business Monthly.