By Karen Sheehan, MD
I did not realize how much I would cherish being the pediatrician to children of parents who were once my patients. It is a rare privilege that not many pediatricians enjoy because of societal mobility and constantly changing health plans.
But there is a downside as well. I have a few parents who are my former patients who struggle with health issues that have their origins in their own childhood experiences. At each second-generation child visit, I am reminded it would have been better to intervene during the parent’s own childhood. However, it is only recently that, as a medical profession, we have evidence that what happens to you in childhood has an impact on your health later in life.
The Adverse Childhood Experiences (ACE) Study, carried out by the Centers for Disease Control and Kaiser Permanente’s Health Appraisal Clinic in San Diego, is the largest epidemiologic study (17,000 patients) to examine the associations between the childhood experiences of abuse, neglect and family dysfunction on adult health. The ACE study findings suggest that certain childhood experiences are major risk factors for severe illness and death. The study also showed that the more adverse childhood experiences one has (such as abuse, household substance abuse or household mental illness), the more likely they are to have poorer health outcomes, such as obesity, depression and heart disease in adulthood.
Now you may be thinking, “So what?” The past is past; it can’t be undone. This is true. But I have found it can be empowering for parents to realize that some of the health problems they struggle with now are because of what happened to them as a child. They may not be able to change their past, but just being aware of how adverse childhood experiences can affect adult health can help one change one’s future. I think it is also motivating for parents to know that they can make a difference for their own children’s adult health by creating safe, supportive homes filled with a caring adult presence.
And the benefit of having caring adults in one’s life isn’t limited to those who live inside the household. We all can remember teachers, coaches or the nice lady next door who looked out for our well-being as we grew up. I like to think pediatricians should be leading this list, for we have the privilege to care for children of generations past, present and — with the increasing age to qualify for full retirement (if one is very lucky) — future generations as well.
Dr. Karen Sheehan is a general pediatrician and a pediatric emergency medicine specialist at Ann & Robert H. Lurie Children’s Hospital of Chicago. After taking care of kids who fell from windows, or were shot, or were hit by cars, it occurred to her that it would be better to prevent such injuries in the first place. She now focuses on prevention and maximizing a child’s health and well-being.