Healthy hearts vs. unhealthy abuse

RALEIGH -- We've all heard it many times. Healthy hearts start with healthy habits.

Although we don't always follow the good advice we hear on an almost daily basis, most of us are very familiar with what we and our families should be doing: don't smoke; eat a healthy diet based on vegetables, fruits and grains; exercise daily; and don't drink excessive amounts of alcohol.

But, how many of us have thought about not using harsh physical discipline with children?

That one doesn't usually jump to the top of our list, and in most cases, doesn't even make the list. But a recent study suggesting that physical abuse in childhood is linked with adult heart disease may have us reconsidering our priorities.

The study, published in the journal Child Abuse and Neglect, analyzed data from 13,000 respondents in the 2005 Canadian Community Health Survey. Of those respondents, 7.4 percent indicated that they had been physically abused as a child and 4.4 percent reported they had been diagnosed with heart disease.

After accounting for most of the known risk factors for heart disease, the study found that adults who experienced physical abuse as children had a 45 percent higher chance of developing heart disease than their peers.

Although the study doesn't explain why children who experience physical abuse are more likely to develop heart disease, the findings are consistent with other studies that have found links between childhood abuse and poor health outcomes such as high blood pressure, obesity and pulmonary disorders.

The Adverse Childhood Experiences (ACE) study, a large-scale study sponsored by the Centers for Disease Control and Prevention and Kaiser Permanente, has found that childhood abuse, neglect and exposure to other traumatic "stressors" are strong and graded risk factors for long-term, chronic health problems, poor quality of life and early death.

In other words, the greater number of adverse childhood experiences that patients in the study reported, the more likely they were experiencing multiple, co-occurring health conditions - such as heart disease, high blood pressure, liver disease and COPD - as adults.

This data aligns with what we are learning about trauma, children's brain development and the lifelong impact that abuse and neglect have on children's ability to learn, thrive and contribute as productive citizens. Science now confirms what many of us have long intuitively known: adverse experiences in childhood damage the emerging architecture of children's brains.

These experiences trigger what scientists now call "toxic stress" - a condition that causes the body to release chemicals which, over time, hinder healthy brain development and jeopardize children's opportunities to learn, grow and develop in a healthy manner.

As a result, children who experience repeated and prolonged trauma are much more likely to grow into youth and young adults who make risky health choices - smoking, overeating, sexual promiscuity and alcohol and drug use. As we all know too well, those choices eventually lead to individual physical and mental health problems and ultimately, seemingly intractable social problems which impact us all.

The science is sobering and the implications so significant that the Centers for Disease Control and Prevention has made child abuse and neglect prevention a priority for the agency and for the nation's prevention efforts. For a country that is more likely to think about preventing the flu than preventing child abuse as a top public health concern, this is a big shift for us to make.

It is, nevertheless, absolutely critical. If we are going to decrease the high incidence of poor health outcomes among our citizens and the high price we pay for those outcomes in skyrocketing medical costs, loss of earnings and loss of quality of life, we must not ignore the impact of negative childhood experiences.

Ensuring our children grow up healthy and ready to lead productive lives is the best investment North Carolina can make in its future. Heart disease is the leading cause of death in the United States, and one in three North Carolinians has some form of heart disease. If we are to have any chance of reversing that trend we must do something now, and it starts with ensuring that our children grow up free from the threat of "toxic stress."

Good heart health and good health in general isn't only about diet, exercise and healthy choices. It is also about ensuring that we provide every North Carolina child with a nurturing, emotionally responsive and stable family and community.