“High stress affects the part of the brain responsible for judgement, memory, reasoning, and problem solving.” – Doctor Nadine Burke Harris
S.E. Williams | Contributor
When California Governor Gavin Newsom appointed Doctor Nadine Burke Harris as the state’s first ever Surgeon General in January 2019, it is almost certain he had no idea just a year ago, how much her expertise would be warranted now that the state finds itself in the midst of a worldwide pandemic.
As Surgeon General, Burke Harris, a leader in public health—particularly in relation to stress and adverse childhood experiences—is charged with significant responsibilities which include advising the Governor. She also serves as the state’s leading spokesperson on matters of public health; and considers the insights of medical professionals, scientists, public health experts, public servants, and everyday citizens in seeking solutions to California’s most persistent public health challenges.
An expert in the study of adverse childhood experiences (ACEs) her leadership during this time of public health crisis could not be more warranted. “There has been conversation in the media about the impact of stress and social isolation, and how that increases the risk of mental health. Family violence may also increase,” she advised.
Consider the following examples of the plethora of recent headlines, “Stay at home orders affect mental health;” “Stay at home causing stress for many, including those still at work;” “As stay at home orders increase, so do feelings of loneliness;” “Stay at home orders are stressing U.S. families, survey shows”; “Children at heightened risk of abuse, neglect;” “Children more at risk for abuse and neglect amid coronavirus pandemic.;” “A man feared his longtime girlfriend had COVID-19, which she didn’t. They died in a murder-suicide, police say;” “Domestic violence, COVID-19 isolation concerns raised after apparent murder-suicides.”
When asked, as Surgeon General, what keeps her up at night while the nation wages a protracted battle against this virus, she acknowledged there is quite a bit. “But I would say, if I had to list one thing keeping me up more than anything else,” she explained. “It is reports of child maltreatment having declined by 40 to 50 percent.”
“It’s worrisome because we recognize during this time of heightened stress, that the numbers are very, very, very low. The greater likelihood [of these data] is kids are not coming into contact with ‘safe adults’ who recognize their cry for help. That is extremely concerning for me.” Family violence may also increase the risk of illnesses like diabetes and asthma according to the doctor.
When discussing under-lying health conditions in relation to the coronavirus like heart disease, high blood pressure, asthma and diabetes, she added, “All these things that have a higher prevalence in the African American community. They are also more susceptible to developing stress disorders. If you’ve had a history of adversity, this added stress of the coronavirus is more likely to trigger an adverse reaction.”
The doctor explained further how, “During times of heightened stress our bodies make more stress hormones, including adrenaline and cortisol, and these can affect our health, our behaviors and our emotions.”
One action Burke Harris has continued to highlight is how important it is for everyone to manage stress and anxiety during this time of crisis for the benefit of their overall health—both physical and mental. To this end, earlier this month Burke Harris introduced the California Surgeon General’s Playbook on Stress Relief During COVID-19. There is also a companion playbook that includes tips for caregivers and kids.
In the Playbook the Surgeon General acknowledged adhering to public health policies and the interventions necessary to slow the spread of COVID-19 are affecting all facets of society and daily life. “These daily disruptions, coupled with the fear of not knowing what may come, are resulting in increased stress and anxiety for many.”
The Playbook is a great tool because it includes simple things people can do every day to protect their health while also helping to manage their stress response. The playbook includes “evidence-based” guidelines on how to reduce through six stress busting strategies and a self-care template.
For those who have a history of adversity, in addition to the six tools presented in the Playbook, Burke Harris offered, “I would recommend anyone with high blood pressure, diabetes or any chronic health condition that can be made worse by stress, to check your blood pressure or blood sugar [as appropriate] more carefully and be in close contact with your doctor.”
As a leading researcher on childhood adversity, the science of toxic stress and as a pediatrician, Burke Harris also commented regarding how to talk to kids about what is going on and the importance of watching for signs when children are feeling stressed.
“Navigating stress with kids is a big part of the reason why I talk about age appropriate language,” she explained. According to the doctor, often when parents talk to kids, they do not speak directly or openly with them. “So, the kids make up their own stories and often, the stories they tell themselves or siblings are worse.”
She continued, “Being able to say very directly to kids without beating around the bush, with age appropriate language, ‘Yes, momma’s feeling really worried.’”
Let them know, she said, there is a virus that is making people sick. “Talk about what’s happening, about staying home and connect that with language that is empowering.” An example she provided for younger children included saying something like, ‘You know how we fight the coronavirus? By washing our hands.” And then, go on to compliment them for doing a great job when they wash them. She cautioned however, it is important to watch for any changes in your child’s behavior as it can be a possible sign of stress in kids; advising it is important to identify such changes and act early.
Of course, you would approach the conversation differently with teenagers. As Burke Harris expounded, “Be open and age appropriate in your conversations. It is different for each developmental stage, plus parents know their kids best.”
She further encouraged parents not to shy away from the conversation as research shows kids who do best are ones who have parent(s) or caregiver(s) who are open with them.
The Surgeon General’s counsel regarding stress and openness did not end with young children. She also pointed to the importance of family and social relationships during the current public health crisis by emphasizing how, “Safe, stable and nurturing relationships, help to protect our brains and bodies from the harmful effects of stress and adversity.”
As the state’s first Surgeon General, Burke Harris has established early childhood, health equity, ACEs and toxic stress as key priorities and has set a bold goal to reduce ACEs and toxic stress by half in one generation.
Burke Harris—with the support of Governor Newsom and in partnership with California Health and Human Services Secretary Dr. Mark Ghaly and statewide health and community leaders—Burke Harris is advancing systemic reforms in California designed to recognize and respond to the effects of ACEs on lifelong health.
To learn more about how childhood trauma affects health across a lifetime, watch Doctor Burke Harris’ Ted talk. For more information on the ACEs Aware Initiative visit www.ACEsAware.org. For information statewide information on COVID-19 visit covid19.ca.gov.