As the country reckons with the COVID-19 pandemic, a global response to racialized violence, and a divided populace, the exposure to trauma grows exponentially. Adverse childhood experiences (ACEs), broadly defined as stressful or traumatic events that occur before the age of 18, present a parallel, yet long-lived and insidious epidemic given their prevalence in the lives of people of all backgrounds.
If an individual experiences four or more ACEs, the risk of chronic disease increases significantly, and if that number exceeds six, life expectancy is 20 years shorter. Further, there are higher rates of ACEs among communities of color, and differing impacts of ACEs by gender with women being more likely to have mental health concerns and men more likely to report substance use. Knowing the impact of ACEs on health is a call to action that states and communities across the country are answering.
Pre-pandemic, New Jersey estimated that more than 40 percent of its children — nearly 800,0000 — had experienced at least one ACE, and nearly 20 percent were estimated to have experienced multiple ACEs. Among the state’s youngest children (under five-years-old), a full-third had experienced one or more ACEs. It is against this backdrop that committed stakeholders across New Jersey have spent the last two years developing the NJ ACEs Action Plan, a statewide plan to address ACEs that was released today.
The Center for Health Care Strategies helped lead the NJ ACEs Action Plan development process through support from the New Jersey ACEs Collaborative. The Collaborative consists of three New Jersey-based foundations — The Burke Foundation, The Nicholson Foundation, and the Turrell Fund — and the New Jersey Department of Children and Families, that came together to advance a coordinated statewide response to tackle ACEs. Through support from this unique collaborative, CHCS provides ongoing assistance to the newly created New Jersey Office of Resilience (OOR) and recently launched the NJ Resiliency Coalition, an online community engagement and information-sharing mechanism designed to facilitate the implementation of the action plan.
New Jersey Takes Action
There has been significant work to address ACEs in communities and programs across New Jersey for years, but much of that work has been siloed. The New Jersey ACEs Action Plan is designed to unite these efforts into a coordinated response through commitments at the gubernatorial and commissioner level across state agencies. To that end, New Jersey created the ACEs Interagency Team, comprised of key decision-makers across state government, to move forward the goal of being a trauma-informed/healing-centered state. The Interagency Team is led by the commissioner of the department of children and families and the executive director of the OOR, who are jointly responsible for the implementation of the action plan, and convenes monthly to coordinate ACE-related efforts and use their programs and policies to advance the statewide agenda.
Further, communities and individuals most directly impacted by ACEs have been central to the planning and prioritization process. The insights they provided during the focus groups form the basis from which the core strategies were developed.
The action plan centers on five core strategies and associated activities:
- Achieve Trauma-Informed and Healing-Centered State Designation — Harness existing ACEs and trauma-informed/healing-centered care initiatives across New Jersey; inform public policy; impact the allocation of resources; and engage philanthropy, the business community, and community-based organizations in making New Jersey a trauma-informed state. Seek gubernatorial declaration of the state as trauma-informed.
- Conduct an ACEs Public Awareness and Mobilization Campaign — Increase public awareness and understanding of ACEs across New Jersey; establish shared language; and highlight existing resources and efforts and improve access to both.
- Maintain Community-Driven Policy and Funding Priorities — Ensure community ownership of efforts to increase the number and quality of trauma-informed/healing-centered, resilience-building programs available to those most impacted by ACEs.
- Provide Cross-Sector ACEs Training — Coordinate the provision of educational programming for community members and a variety of child- and family-facing sectors to support culturally appropriate, trauma-responsive engagement with children and families.
- Promote Trauma-Informed and Healing-Centered Services and Supports — Ensure access to trauma-informed/healing-centered services and supports to children in the context of their families and those families in the context of their communities.
With the release of the action plan, the OOR is seeking partners throughout the state across all sectors — including those most directly impacted by ACEs — to support this work. It is also overseeing the development of a technical assistance resource center that will support the implementation, monitoring, and evaluation of action plan-related efforts.
Addressing ACEs: A National Priority
New Jersey’s commitment to addressing ACEs on a statewide level is illustrative of efforts emerging across the country. New Jersey is one of several states to put forward a plan to address ACEs, though each has taken a slightly different approach in their commitment to support systemic efforts. Statewide efforts around the country include:
- An Executive Order in Delaware;
- Statewide initiatives in California;
- Cross-sector consortia in Arizona;
- Data-informed efforts based on homegrown ACEs studies in Pennsylvania; and
- Public-private partnerships in Oregon.
At the local level, cities like Philadelphia are conducting their own Philadelphia ACE Study to account for the different demographics and ACEs in an urban setting. In Washington State, numerous counties are developing approaches tailored to their needs and seeing quantifiable decreases in negative outcomes, like juvenile justice involvement, teen drug arrests, youth suicide, and domestic violence. Responding to the growing state interest to confront ACEs, the National Governors’ Association is overseeing a state learning collaborative focused on recognizing and responding to ACEs.
Addressing ACEs on a broad scale is as important as ever, especially in light of the COVID-19 pandemic and the myriad of ways it has changed so many lives. Statewide efforts, like those in New Jersey, offer an opportunity to intervene, support resilience, and prevent ACEs to promote positive impacts on the health and social outcomes of millions of Americans for generations.