On July 20th, Pathways to Resilience hosted a Learning Network Session on “Exposure to Racism and Discrimination as Sources of Trauma and Toxic Stress” with Roy Wade, Jr., MD, PhD, MPH, MSHP. Dr. Wade discussed his work on the Philadelphia Expanded Adverse Childhood Experiences (ACE) Study, which explored additional community-level adversities not covered in the original ACE study, such as witnessing violence and experiencing discrimination. Participants in the Philadelphia ACE Study were also more socioeconomically and racially diverse than those of the original ACE study, which was conducted among a primarily White, middleclass, college educated, and privately insured population in San Diego, California.

Dr. Wade translated some of his research findings into the following actionable strategies for policymakers.

  • Support and train people who work with children and families on the importance of consistent, caring relationships. A person who has experienced trauma is more likely to heal and thrive if they have a consistent relationship with a caring adult. Think about the various members in your community who already serve in this role — clergy, teachers, etc. — and ways you can boost their knowledge and understanding of the importance of consistent, caring relationships.
  • Work across sectors to align as a cohesive system of care. It is likely that the people you serve are also involved in other systems within your community. Although you may share common goals with these other service providers, your approaches may differ and inadvertently cause additional stress for families. Wade reflected on an example where his pediatric practice urged parents to reduce children’s juice consumption as a strategy to reduce sugar intake while another local agency was simultaneously providing the same families with free juice. Think about the other systems your clients are likely to interact with. Are there ways you can connect with and align with these other service providers?
  • Take a strength-based approach. As policy makers and service providers, we often focus on the problems we are trying to overcome. An alternative strategy can begin with taking stock of the positive factors and strengths. How can you take a strengths-based approach to solve problems?
  • Consider how assessing for adversity can help you provide better care. Short of a full screening for ACEs and other adversities, an assessment can provide you with valuable information that can help you offer client-centered, individualized care right there in your office, without the need for any referrals or formal follow-up. Learning about someone’s history can help you identify when you may want to take additional time to listen and provide support. Dr. Wade provided an example where he recognized that a patient along with two generations of family before them had experienced trauma. By investing additional time with this family during their visit, he was able to provide support needed to interrupt the intergenerational transmission of trauma.

Dr. Wade is an Associate Professor of Pediatrics and a general pediatrician at Children’s Hospital of Philadelphia and serves as a member of the Pathways to Resilience Advisory Committee. Dr. Wade’s work focuses on the connection between childhood adversity, poverty, and well-being and aims to improve community-level systems of care and access to protective factors.

Further Reading

Dr. Wade has published the following articles based on his research.

The following articles offer additional research on racism and life course effects.

Participate in Future Learning Network Sessions

Learning Network Sessions will continue to feature renowned speakers; actionable, concrete strategies for states and communities; and opportunities for dialogue. The audience for Learning Network Sessions is state and local government employees.

Upcoming sessions include:

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