Kaiser Permanente on Wednesday said it will invest $2.75 million to research how to help prevent and mitigate the health effects of adverse childhood experiences.
The funding will go toward an initiative to identify clinical and community-based interventions that can be used to address childhood trauma. Studies have indicated those adverse events can lead to riskier health behaviors and a higher likelihood of developing chronic conditions in adulthood.
Kaiser Chairman and CEO Bernard Tyson said he viewed the research initiative as part of the health system's work toward providing a "total health" approach to the communities they serve by addressing the most pressing societal issues that are negatively impacting their members' health.
"When a child is in an environment or situation where they are being adversely impacted it has long-term repercussions to the health and well-being of that individual," Tyson said. "Our interest is to hopefully rewire for that not to happen, and if we can't do that then buffer and give skills to the child to cope with the situation."
Tyson said the new research will build on the system's past work investigating adverse childhood events. In 1998, the system and the Centers for Disease Control and Prevention released a landmark study on the health effects of adverse childhood experiences which found that adverse childhood events, or ACEs, led to increased risk of earlier death.
Children who have four or more ACEs were 12 times more likely to attempt suicide, according to the Kaiser-CDC study, and those with six or more have a 20-year shorter life expectancy. ACEs can include all types of abuse and neglect as well as household dysfunction, substance use, divorce, parental incarceration, domestic violence, systemic racism and living in a high-crime neighborhood.
A study published in the American Journal of Preventive Medicine in May found households paid $311 more on average annually in out-of-pocket healthcare costs and had more than two times as much medical debt when an adult reported having three or more adverse childhood experiences compared with individuals who had no childhood traumas.
"What this is intended to do is more around solutions and ultimately going more upstream, which is the sweet spot," Tyson said.
Kaiser's research effort will begin with a systematic review of existing research on ACEs to help identify gaps in current knowledge; that review is now underway. The goal is to find successful programs and best practices that could possibly be scaled up for use across communities. The review will guide the formation of the research program and target investments in new areas of research.
Dr. Don Mordecai, Kaiser Permanente's national leader for mental health and wellness, said he expected to issue a request for proposals to the health system's internal research groups for ACEs-related research by next year. He said grants will be issued in 2021 with an expectation of seeing the first research findings sometime around 2022.
Some of the initial focus areas for the research may include identifying factors that could prevent ACEs, ways of mitigating their negative effects throughout a child's life and finding the most effective community-based services that can address adverse experiences.
"We're particularly interested in ways to kind of knit together the promising solutions so that we have a system that addresses families when they're in formation," Mordecai said. "We want to think about it developmentally from the perspective of the child and then sort of inter-generationally."
