Toxic stress is a public health crisis, Dr. Nadine Burke Harris tells Erikson audience

Speaking at an Erikson President’s Council event, the nationally renowned pediatrician discussed the need to broadly treat adverse childhood experiences.

For years, pediatrician Dr. Nadine Burke Harris treated children’s chronic conditions the way she was taught in medical school: Prescribing medication to ease symptoms. But it was a conversation with a 10-year-old patient’s mother that got her thinking differently.

“The mother said to me, and I’ll never forget this, ‘I noticed my daughter’s asthma acts up every time her dad punches a hole in the wall,’” Dr. Burke Harris told a crowd of Erikson Institute supporters, alumni, faculty, and staff at a recent President’s Council event. “Hearing those histories, hearing that in patient after patient after patient, I started to connect the dots.”

“Connecting the dots” meant learning to address the underlying issue of many patients’ medical conditions: Adverse childhood experiences — traumatizing events early in life that research has shown can lead to life-altering and life-threatening diseases in adulthood. During her President’s Council talk, Erikson’s first such event of 2018, Dr. Burke Harris discussed the need to treat exposure to adverse childhood experiences and the “toxic stress” they cause as a public health emergency.

A shared passion

Erikson’s President’s Council recognizes our leadership-level donors with unique programming around issues important to Erikson, reflecting our leadership in the early childhood field and helping to expand our impact by fostering important conversations.

Among the issues close to Erikson are childhood trauma and toxic stress, which are also the subjects of Dr. Burke Harris’ new book, “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.” At Erikson, trauma and toxic stress are the focus of our study on the impact of mindfulness techniques in the Chicago Public Schools. In addition, our clinicians who work around the state regularly serve young children and families who have experienced extreme adversity in their lives.

“Dr. Burke Harris shares a passion with Erikson of meeting the needs of all children — especially those at risk,” said Geoffrey A. Nagle, PhD, president and chief executive officer of Erikson. “Our work intersects in many ways, and we share many of the same goals. With a background in public health myself, I’m pleased that Dr. Burke Harris frames the issue of adverse childhood experiences as a public health crisis.”

Even before she began working on her book, Dr. Burke Harris was known as a crusading physician delivering targeted care to vulnerable children through her pediatric practice in one of San Francisco’s poorest neighborhoods. Now, her work around toxic stress — helping explain what it is, how it affects children, and how society can break the cycle — has amplified her role as national advocate.

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An elevated health risk

Since an initial study in the 1990s identified the link between adverse childhood experiences, or ACEs, and negative health outcomes, the Centers for Disease Control has collected data in 32 states and Washington, D.C., Dr. Burke Harris said.

“The CDC found that 13 to 17 percent of the population had experienced four or more ACEs, and the higher your ACE score, the worse your health outcomes,” she said. “Four or more ACEs doubles risk for heart disease and cancer. There is two-and-a-half times the risk for stroke and four times the risk for chronic lung disease. A score of four or more dramatically increases the risk for seven out of 10 of leading causes of death in the United States.”

Framing toxic stress in terms of a fight-or-flight response, she talked about how children exposed to adverse experiences, such as abuse, poverty, and violence in the community, constantly feel as if their bodies are in survival mode.

“When we experience something scary or frightening or traumatic, it activates the alarm center of our brain and releases stress hormones,” she said. “That’s awesome: We are either ready to fight that bear or run from that bear. The problem is, what happens when that bear comes home every night? This system is activated over and over and over again. It goes from being adaptive or life-saving to maladaptive or life-damaging.”

Next steps

Addressing this widespread health issue, she said, begins with raising awareness and continues with implementing a system, similar to one she uses in her pediatric practice, that allows for physicians to screen patients on a broad scale for exposure to adverse childhood experiences.

Families interested in better understanding the potential impact of adverse childhood experiences, she said, might want to start by visiting, where they can take a quiz to determine their own or their children’s own ACEs scores.

“That is how you start a revolution,” she said, quoting from her book. “You shift the frame, change the lens, and all at once, the world is revealed, and nothing is the same.”


Dr. Nadine Burke Harris’ talk was sponsored by DLA Piper, which generously hosted the event at its offices. For more information about becoming a member of Erikson’s President’s Council, contact Dee Dee Chesley at [email protected].

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