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A community that’s present when you need it

October 18, 2017
Amy H. Peterson - Staff Writer ( , Estherville News

Pottawattamie. Woodbury, Polk, Clinton, Johnson. Muscatine. Jasper., Black Hawk. What do these counties have in common? They are some of the counties that contain Iowa's urban areas. They're also counties that scored high, over 12 percent, on the Iowa ACEs assessment.

The original Adverse Childhood Experiences Study (ACEs) was conducted in the mid-1990s. It revealed how strongly negative experiences in childhood can derail a child's development, and lead to a host of health and social challenges throughout a lifetime.

The most recent report on the data provides emerging response strategies. The purpose is to improve the health and well-being of Iowans and create a brighter future for our communities. ACEs are divided into eight categories: emotional abuse, physical abuse, sexual abuse, substance abuse in the home, incarcerated family member, family member with mental illness, domestic violence, and separation/divorce.

What does this have to do with us? The urban areas, and some other rural ones scored high, it's true. Emmet County wins, in a way we don't want to win. With the exception of Pottawattamie County at 17.4 percent, Emmet County has the highest percent of adults reporting four or more ACEs at 17.1 percent.

This hit me hard. What happened to our people? Are we perpetuating further generations of trauma? Are we still experiencing the fallout from the Morrell plant closing 30 years ago? The kids growing up with hardships from that becoming adults and having kids, and some of those kids growing up and having great grandkids of the Morrell workers? Probably not? Then what's at the root of it?

It's not a factor of the isolation of our rural area: Palo Alto county residents reported 5.2 percent, Kossuth 6.6, Clay 9.4, and Dickinson 11.8. Most of the other counties in rural northwest Iowa are in the single digits, with the other exceptions including Cherokee at 12.4 percent, Pocahontas, 10.7, and Sac 11.8.

I know I'm throwing around a lot of numbers. What do they mean?

As I'm reading them, it means nearly 1 in 5 adults in Emmet County reports that they experienced at least half of the categories of trauma in their childhoods.

To be clear, this doesn't mean they spent their childhoods in Emmet County; this is reporting where they live now. But many of our residents were born, raised, and still live here.

So they had a traumatic childhood. Can't they overcome it as adults? Yes, with resilience and the replacement of the negative things with positive things, but possibly not entirely no matter how hard they try. Childhood trauma is common among adults regardless of age, race and education level, according to data from the original study.

Full disclosure: I have an ACEs score of three, and they are factors that happened when I was at least 12; hence my earliest years were virtually ACEs-free. The study states that this factor is very important. Our brains grow the most between ages birth to five, and the more nurturing, inclusion, and protection from ACEs we have in the earliest years, the better the outcome. That doesn't mean we should decrease our nurturing of the tweens and teens in our lives. It means if you've made it that far and things have been safe and healthy, that's huge!

Now to overcoming these challenges: CDC research has found that trauma in childhood could reduce life expectancy by up to 20 years. The health risks of early toxic stress cannot be attributed to behavior alone. The authors of the original study looked at individuals with an ACEs score of seven or higher who didn't smoke, didn't drink to excess, and weren't overweight. They found the risk of ischemic heart disease (the most common cause of death in the U.S.) among this group was 360 percent higher than those with an ACEs score of zero. The stress really will kill you.

Dr. Nadine Burke Harris from the Center for Youth Wellness writes, "When you look at adverse childhood experiences, they're actually a stronger predictor of risk of ischemic heart disease than any of the traditional risk factors when you think of high blood pressure, high cholesterol, and smoking."

Why Emmet County? The short answers statewide are poverty (but Emmet is not the most impoverished area of Iowa); more children with special needs and delays, the fact that 25 percent of Iowa women who are mothers of young children have a high school diploma or less (making it difficult to find a job let's encourage girls/young women especially to stay in school or drop back in); and the fact that 30.8 percent of Iowa families are headed by a single parent (but I don't think that means a dysfunctional, angry couple should stay together "for the kids" most now-adult kids whose parents did this wish they hadn't, and there are good divorces/co-parenting plans. Let's make more of these happen).

Mental health

On the latest community health needs assessment by Avera Holy Family Hospital, the number one reported need in the community was mental health. When I talk to you in the community and the topic comes up, this is your consensus, too. We need more than what we have for mental health help. Without going into the factors of mental health too deeply this time, think on this: according to the study, Iowa adults with four or more ACEs (our 17.1 percent in Emmet County) are six times more likely to have been diagnosed with depression. Across the state, those with four or more ACEs report that "All" or "Most of the time" they are restless, feel everything is an effort, are nervous, feel hopeless, worthless, and so depressed nothing could cheer them up.

If ischemic heart disease has spared them so far, suicide might not.

I'm not here to make you feel depressed in the moment, and most of you who talk to me about my columns say you're happy I dive into these truths.

The short answer is trauma-informed care. It helps survivors of trauma rebuild a sense of control and empowerment. You can find out more at

I don't know if one in five people in Emmet County have access to trauma-informed care. For now, maybe we would do best by being there for each other and making our community a safe and nurturing place.



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