Whole Health Louisiana State Plan


Across Louisiana, childhood adversity and trauma affect a significant number of children and families, potentially disrupting all aspects of health. Failing to recognize these experiences and respond in ways that are grounded in the science of adversity and resilience can have profound consequences for the well-being of our state. Due to the historical and contemporary lack of coordinated, supportive systems for children and families, opportunities to provide or strengthen individual- and community-level preventative and protective factors have not been fully realized. Research reveals that children who experience toxic stress as a result of trauma exposure without the buffer of supportive interventions can experience long-term health problems, such as diabetes and heart disease, impacting their wellbeing but also their life span. Moreover, these challenges translate into increased strains on healthcare and mental health services. Individuals may experience involvement with child welfare and juvenile legal systems, as well as obstacles to forming stable relationships and securing employment. Experts in the field have identified unaddressed adverse childhood experiences as the single biggest predictor for later problems in adult health and well-being. The annual economic cost of childhood adversity-related health consequences in North America is estimated at $748 billion. This includes the costs associated with confirmed child maltreatment cases and financial implications that extend throughout a lifetime attributed to the cost of disease burden, including premature death and years of productive life lost to disability. Failure to address childhood adversity and its impacts correlate to substantial economic costs at the state level.

What is Childhood Adversity?

Childhood adversity refers to a wide range of circumstances or events that pose a serious threat to a child’s physical or psychological well-being. Childhood adversity may occur during prenatal development and all other developmental stages, from infancy through adolescence. While adversity can be experienced as harmful at any age, unbuffered adversity early in life can impair critical brain and biological systems development and functioning. Adversity at any developmental stage can be experienced as traumatic; however, not all adversity results in trauma. Many adverse childhood experiences, such as abuse, neglect, or exposure to violence, have the potential to be traumatic for a child, but protective factors such as having basic needs met, safe and nurturing relationships, and access to culturally responsive mental and behavioral healthcare can play a significant role in mitigating the traumatic impact of adversity experienced at the individual, community or collective levels. The more severe and chronic the adversity, the greater the risk of it leading to trauma.

What is Trauma?

Trauma refers to single events or chronic conditions that interrupt or inhibit the development of safety, agency, dignity, and/or belonging. Trauma results when interruptions in safety, agency, dignity, or belonging overwhelm a person’s coping abilities. This can lead to temporary and/or lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, and/or spiritual well-being. Many people think about trauma at the individual level, but it is important to understand that trauma occurs at multiple levels. Trauma at all levels can be exacerbated by formal and informal social structures, policies, and cultural ideologies that create harm. For example, although disasters affect everyone, they often exacerbate long-standing disparities and inequities experienced by people from racial and ethnic minority groups, people with low incomes, and other communities with less power and access to resources. Decades of systemic and environmental injustices have resulted in these groups being disproportionately affected by disasters. A recent study of the impacts of urban flooding found its impacts are most harmful to Black communities, and Black neighborhoods are less likely to receive flood protection. Systemic and structural inequities create disparities in both trauma exposure and impacts by contributing to a greater experience of secondary disaster-related traumatic experiences among Black, Hispanic, and Native American communities related to displacement as a result of the disaster, delays in restoration of infrastructure services, lack of access to health care, and loss of social networks in the weeks and months following the disaster.


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