“With increased socioeconomic status, there's going to be healthier protective factors,” Ballestas said. “If you have healthier protective factors, those are tools that are going to protect from social determinants of health. If you have mental illness, and you have resources such as a healthy family, access to tutoring, access to extracurricular activities that increase a sense of self-efficacy, these are all protective factors that will decrease long-term outcomes of mental illness.”
Even for facilities like La Rabida, which operates a pediatric trauma center, the health impact of violence is not always identified among all its patients, Soglin acknowledged.
“For those severely impacted kids, they need intensive therapy, and that's what our trauma center is for,” Soglin said. “But for the kids in the neighborhoods who have not necessarily been shot but know people who have been shot and have seen people be shot, we don't at this point have good resources for them.”
Part of the problem, Soglin said, is that many healthcare providers don't recognize the role that the stress of living in impoverished communities with high rates of violence can play in causing poorer health outcomes.
Soglin said talks were just underway at La Rabida to screen all kids who visit the hospital for signs of toxic stress regardless of whether they were in a trauma patient. He hopes to begin the testing in about a year.
“If there was a virus out there that you got as a child and it decreased your adult life span by 20 years, we would be all over it to look for a vaccine or whatever we needed to do,” Soglin said. “The adult world, to me, seems to be completely unaware of the impact of childhood experiences on the health of their patients.”