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News & Press: MPCA News

ACEs Initiative Could Save Michigan's Youth, If We Let It

Tuesday, July 3, 2018  
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by Loretta V. Bush, MSHA, CEO

Imagine: what if a 10-question assessment could add 20 years to a patient’s life?

The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study has shown that exposure to adverse events in childhood — divorce, domestic violence, abuse, poverty, neglect — has a negative impact on a number of health metrics that follow these kids through life. It’s not necessarily because they’re engaging in risky behaviors, either. Traumatic stress in children triggers real changes in brain chemistry and architecture, DNA, physiology, and immune response. Children with four or more ACEs are 32 times more likely to have learning or behavior problems in school as kids with no ACEs. And, perhaps most shockingly, data suggest that people die 20 years sooner when they have six or more ACEs.

As the number of adverse childhood events increases, so do poor mental and physical health outcomes. These chronic conditions are expensive to treat, too. In fact, one-third of all health care costs in Michigan are directly related to high ACE scores. This data has significant implications for payment reform. As we move toward value-based care that prioritizes outcomes over encounters, we’ll be compelled to assess and address ACEs so that we reliably improve health outcomes — and therefore save money.

But we also need to turn our attention to the human costs.

If we know that ACEs have wide-ranging health and social consequences, we have a moral obligation to find ways to prevent or mitigate them. We — providers, social workers, parents, mentors, coaches, teachers, and friends — have the ability to help children build resilience and break cycles of generational trauma. We need a massive culture shift that focuses on “what happened to you?” versus “what’s wrong with you?”

That’s why the Michigan Association of Health Plans Foundation, thanks to funding from the Michigan Health Endowment Fund, created the Michigan ACE Initiative. Their goal is to increase statewide awareness, develop a statewide coalition to recommend appropriate interventions and state policy, and shape Medicaid policy to better respond to ACEs. They’re training people who interact with kids on a regular basis to understand behaviors that exemplify ACEs and connect them to the medical, behavioral, and social supports they need in their communities.

I look at Michigan’s community health centers as the perfect places to start those 10-question ACEs screenings. Health centers are already providing the integrated care necessary, often all under one roof, to get children on the right track. If a member of the care team finds that a child has six or more ACEs and provides targeted interventions and wraparound services right away, we can help make sure that child doesn’t end up a statistic.

The MPCA is going to make this easier for you, too. At our annual conference this July, you’ll have an opportunity to learn about resources and training that will give you the tools you need to implement ACEs assessments in your health centers. This isn’t just another piece of paperwork or obligation — it’s an opportunity to reduce seven out of 10 leading causes of death, diminish disease before damage occurs, and ensure that Michiganders have every opportunity to live full, productive lives.

I hope you’ll watch the ACEs Initiative video and commit your teams to brighter, healthier futures for Michigan’s youth.


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