Preventive Health Care through Community Cohesion
I recently watched “Resilience,” which talks about adverse childhood experiences (ACEs) and toxic stress. The combination of having a high ACE score and little-to-no protective relationships has been shown to increase the risk of a whole host of poor health outcomes like heart disease, obesity, liver disease, an increased risk of substance abuse and mental health disorders, and many, many more. The Center for the Developing Child at Harvard defines toxic stress for children as “strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems and increase the risk for stress-related disease and cognitive impairment.” Modifying this definition only slightly also allows us to think about toxic stress at the community level and how it affects population-wide health outcomes.
In much of the ACE research, it’s said that while children’s brains may not remember traumatic experiences, their bodies don’t forget. Similarly, communities often have histories that include traumas (like slavery, systemic racism, civic unrest, high unemployment, natural and human-caused disasters, and/or other “shocks to the system”). Although those traumas can leave lasting scars and can negatively impact health outcomes throughout entire populations, communities are too often encouraged to repress them, ignore them, “get over it,” or “move on.”
Stress is inevitable for all of us. For both individuals and communities, difficult situations can result in navel gazing, deficit thinking, and focusing only on shortcomings. Assets and so much positive potential can be overlooked, marginalized, or cut short, especially when there is pressure to put the past behind and only look to the future.
However, addressing traumatic histories and connecting with others around them may provide an avenue for collective healing. Community-level relationships can help build resilience through expanded perspectives, supportive networks, shifting power, and a sense of cohesion. Those relationships are often developed through collaborative learning and networking, coalition building, open community dialogue, and/or learning through other formal or informal exchanges. In addition to the inherent value of strengthening relationships, positive community change is often championed by passionate individuals, organizations, and the strength in numbers that comes from movement building. During our years of work supporting healthy community change, we have seen how collaboration can create community change, from Benton County, OR to Syracuse, NY to Columbia, MO, and many more.
We know that in order for us to learn and grow from traumas, whether they are isolated events or sustained experiences, we need to take the time to reflect, process, and consider what we’ll do to cope, brace ourselves for future stresses, and ultimately change our situation so that some histories don’t repeat themselves. And when traumas happen to entire communities, that healing must happen collectively.
