Health is a universal right, but not universally experienced. Instead, health disparities are prevalent in communities across the country and primarily affect marginalized populations. To better understand the causes and consequences of these disparities, Middlelayers has partnered with and learned from community organizations, government officials, and educators on the front lines of poverty alleviation and population health efforts. Together with our partner organizations, Middlelayers held community forums in Middletown, OH, Morgantown, WV, Brunswick, GA, and Jacksonville, FL. The forums began with a showing of our documentary film, Replicating a J.D. Vance Anomaly, followed by a panel discussion on local barriers to health.

A common theme throughout the forums was the strong correlation between conditions in early childhood and lifelong health outcomes. Specifically, discussions focused on Adverse Childhood Experiences (ACEs), or incidents of childhood trauma, which exert powerful and cumulative effects on adult health. While ACEs are common among all populations, the number of ACEs experienced is inversely correlated with family socio-economic status.

According to Dr. Kristi Moilenan, an Association Professor in the West Virginia University Department of Learning Sciences and Human Development, toxic stress produced by ACEs reshapes the architecture of a child’s developing brain and body. Toxic stress can disrupt learning, future development, and immune system functions and lead to the adoption of risky health behaviors. Middletown Health Commissioner Jackie Phillips elaborated, stating that “When you have a lot of trauma in your life, you try to numb or escape that trauma, and you do that by (engaging in) high-risk behaviors.” These high-risk behaviors can then lead to chronic illness and premature death. Added Phillips, “If it is drugs or alcohol, then you get liver disease. If it is high-risk sexual activity, you can get HIV or sexually transmitted diseases.”

To mitigate ACEs, forum participants unanimously advocated for early, dual-generational interventions, such as those delivered through adult-to-youth and parent-to-parent mentorship programs. These interventions work with children to build their resilience to risk while also helping parents become supportive, protective factors in their children’s lives. Cities like Middletown and Brunswick are working to invest more mentorship program that support the whole child and whole family in an effort to end cycles of poverty, trauma, and poor health that affects their most vulnerable populations.