Leveraging Surveillance and Evidence: Preventing Adverse Childhood Experiences Through Data to Action.

Adverse childhood experiences are potentially traumatic events that occur in childhood that have been associated with lifelong chronic health problems, mental illness, substance misuse, and decreased life opportunities. Therefore, preventing adverse childhood experiences is critical to improving health and socioeconomic outcomes throughout the lifespan. The Preventing Adverse Childhood Experiences: Data to Action (CDC-RFA-CE20-2006) funding initiative is a comprehensive public health approach to adverse childhood experience prevention that aims to understand the prevalence of and risk factors for adverse childhood experiences among youth, track changes in adverse childhood experience prevalence over time, focus prevention strategies, and ultimately measure the success of those evidence-based prevention strategies. Recipients will achieve the goals of the initiative by leveraging multisector partnerships and resources to: (1) enhance and build infrastructure for state-level data collection, analysis, and application of adverse childhood experiences related surveillance data; (2) implement at least 2 prevention strategies based on the best available evidence to prevent adverse childhood experiences; and (3) undertake data to action activities to leverage statewide surveillance data to inform and tailor adverse childhood experience prevention activities. Since the start of this initiative, recipients have focused on building surveillance capacity based on the needs of their individual states; implementing strategies and approaches based on the best available evidence to better prevent adverse childhood experiences; and ultimately improve the mental, physical, and social well-being of their populations. Although evaluation of Preventing Adverse Childhood Experiences: Data to Action is ongoing, this article outlines the current recipient surveillance, prevention, and data-to-action implementation efforts.

Adverse Childhood Experiences and Overdose: Lessons From Overdose Data to Action.

INTRODUCTION: Adverse childhood experiences and overdose are linked in a cycle that affects individuals and communities across generations. The Centers for Disease Control and Prevention's Overdose Data to Action cooperative agreement supports a comprehensive public health approach to overdose prevention and response activities across the U.S. Exposure to traumatic events during childhood can increase the risk for myriad health outcomes, including overdose; therefore, many Overdose Data to Action recipients leveraged funds to address adverse childhood experiences. METHODS: In 2021, an inventory of Overdose Data to Action‒funded activities implemented in 2019 and 2020 showed that 34 of the 66 recipients proposed overdose prevention activities that support people who have experienced adverse childhood experiences or that focus on preventing the intergenerational transmission of adverse childhood experiences. Activities were coded by adverse childhood experience prevention strategy, level of the social ecology, and whether they focused on neonatal abstinence syndrome. RESULTS: Most activities among Overdose Data to Action recipients occurred at the community level of the social‒ecologic model and under the intervene to lessen harms adverse childhood experience prevention strategy. Of the 84 adverse childhood experience‒related activities taking place across 34 jurisdictions, 44 are focused on neonatal abstinence syndrome. CONCLUSIONS: Study results highlight the opportunities to expand the breadth of adverse childhood experience prevention strategies across the social ecology. Implementing cross-cutting overdose and adverse childhood experience‒related activities that span the social‒ecologic model are critical for population-level change and have the potential for the broadest impact. Focusing on neonatal abstinence syndrome also offers a unique intervention opportunity for both adverse childhood experience and overdose prevention.

Preventing Childhood Adversity Through Economic Support and Social Norm Strategies.

Through the Essentials for Childhood program, the Centers for Disease Control and Prevention funds 7 state health departments (states) to address the urgent public health problem of adverse childhood experiences and child abuse and neglect, in particular. Through interviews and document reviews, the paper highlights the early implementation of 2 primary prevention strategies from the Centers for Disease Control and Prevention's child abuse and neglect technical package with the greatest potential for broad public health impact to prevent adverse childhood experiences-strengthening economic supports and changing social norms. States are focused on advancing family-friendly work policies such as paid family and medical leave, livable wage policies, flexible and consistent work schedules, as well as programs and policies that strengthen household financial security such as increasing access to Earned Income Tax Credit. In addition, states are launching campaigns that focus on reframing the way people think about child abuse and neglect and who is responsible for preventing it. State-level activities such as establishing a diverse coalition of partners, program champions, and state action planning have helped to leverage and align resources needed to implement, evaluate, and sustain programs. States are working to increase awareness and commitment to multisector efforts that reduce adverse childhood experiences and promote safe, stable, nurturing relationships and environments for children. Early learning from this funding opportunity indicates that using a public health approach, states are well positioned to implement comprehensive, primary prevention strategies and approaches to ensure population-level impact for preventing child abuse and neglect and other adverse childhood experience.

The evolution of the overdose epidemic and CDC's research response: a commentary.

The United States drug overdose epidemic has reached an all-time high, with 2020 provisional mortality data indicating that over 90,000 lives were lost to drug overdose in the 12-months ending in December 2020. The overdose epidemic has evolved over time with respect to the substances involved in overdose deaths and also with respect to the geographic distribution and epidemiology of deaths involving specific substances. Thus, a nimble approach to addressing the epidemic and preventing future overdoses is needed. CDC's response to the overdose epidemic supports implementation efforts at the state and local levels, where partners can better detect and respond to the evolving drug overdose landscape and implement prevention measures that meet their needs. CDC's framework for responding to the overdose epidemic focuses on five areas: (1) conducting surveillance and research; (2) building state, local and tribal capacity; (3) supporting providers, health systems and payers; (4) partnering with public safety; and (5) empowering consumers to make safe choices. Central to informing the implementation of evidence-based strategies to prevent drug overdose is rigorous research that undergirds the evidence. This Commentary describes recent investments in overdose prevention research and outlines opportunities for ensuring that future research efforts allow for the flexibility necessary to effectively respond to the continually evolving epidemic.