CYFC Update — September 2016
Moving from "What's Wrong with You?" to "What Happened to You?" When Working with Obese Children
Makshita Luthra, Graduate Assistant — CYFC
Obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. It is often linked to unhealthy eating habits and sedentary lifestyles. Another significant factor associated with obesity in children and adolescents are “adverse childhood experiences,” or ACEs. The Centers for Disease Control and Prevention defines ACEs as childhood experiences, both positive and negative, that have a tremendous impact on future violence victimization and perpetration, as well as lifelong health issues, including obesity. CYFC focuses on ACEs, as well as AFEs (more on those later) in its work with obese children and adolescents.
In 1998, Vincent Felitti, M.D., and Robert Anda, M.D., outlined 10 types of ACEs, of which five are defined as maltreatment — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. The other five are related to the behavior or experience of other family members (Felitti et al, 1998). The combined total is referred to as an individual’s ACE score. As the number of ACEs increases, so does the risk for these outcomes, such as risky health behaviors, chronic health conditions, low life potential, and early death. Children with an ACE score appear in all human service systems throughout their lives — as children, teens, and into adulthood — as clients with behavioral, learning, social, criminal, and chronic health problems.
Extension’s Children, Youth & Family Consortium (CYFC) has focused on children’s mental health for many years and has based its interventions on the belief that mental health does not reside solely within the child, but within the web of interactions with the individual child. One of the most significant interactions is the child’s interaction with family and the environment in which he or she lives. Adverse Family Experiences (AFEs), a subset of ACEs, relate more to the environment and community context than to direct maltreatment. A study conducted by researchers at Mayo Clinic looked at a large national database — the National Survey of Children’s Health (NCSH) 2011-12 — which captured household dysfunction and family exposures, such as divorce or separation of parents, parents' time of incarceration, witness of domestic violence, or experiences living with someone with substance abuse problems, with mental illness, or with suicidal tendencies. The researchers found that among children between 10 and 17 years of age, exposure to two or more adverse family experiences, death of parent, and economic hardship, were independently associated with overweight and obesity status after adjusting for other AFEs and socio-demographic factors.
An essential question here is that “Exactly how are these experiences linked to health risk behaviors such as obesity?” The linking mechanisms appear to center on behaviors, such as overeating, that may be consciously or unconsciously used because they have immediate pharmacological or psychological benefit as coping devices in the face of the stress of family and household dysfunction. Not surprisingly, high levels of exposure to adverse family experiences produce anxiety, anger, and depression, which often lead to overeating as a coping device (Felitti et al, 1998).
Economic hardship is the most common AFE reported nationally and in the state of Minnesota, followed by divorce or separation of a parent or guardian, or life with an adult who has an alcohol or drug problem. While the percentage of children (from infancy to age 17) affected by economic hardship in Minnesota is lower than the national average and the percentage of children affected by separation of parents is similar to the national average, more children in Minnesota live with someone having substance abuse problems compared to the national average (Child Trends Research Brief, 2014).
Substance abuse problems among parents affects their children in multiple ways. When even one parent in the home is abusing alcohol or drugs, the home is significantly more likely to exist in a state of uncertainty and even chaos. The orderliness and predictability that should make home a safe environment are often sacrificed to the parent’s addiction. Not only are expectations unclear and inconsistent, the lack of structure often means that children are left to take on greater self-reliance, taking on the responsibility for keeping the house picked up, preparing their own meals and caring for their younger brothers and sisters. On top of all this, children living with substance-abusing parents often lose the connection with their parents for extended periods of time, which leads them to feel rejected and unimportant. And this, in turn, can lead to overeating and obesity.
When a child grows up in an unpleasant environment, it is not always the case that he or she will abuse substances — or end up obese. It is always possible to break negative cycles. This is what we do at CYFC — we create authentic partnerships with community and find solutions to issues facing children and families.
World Health Organization — http://apps.who.int/adolescent/second-decade/section/section_5/level5_3.php
How Is Children’s Mental Health Is Related to your Work?
CYFC has posted several new annotated bibliographies that reflect the latest research and and draw connections between children’s mental health and related fields. Find articles, books, and guides for using a public health approach to children’s mental health at these links:
Promoting Children's Mental Health — Published Journal Articles — This is a list of journal articles about public health approaches to children’s mental health, ways to frame and speak about mental health, and successful mental health promotion activities throughout childhood.
Mental Health and Nutrition — Published Journal Articles — Review these journal articles on the multi-faceted connections between mental health and nutrition. While many of the articles focus specifically on children, adolescents, and maternal-child dyads, others are broader population studies and research reviews.
Mental Health as a Public Health Issue: Impact of Exercise, Nutrition, and Sleep on Mental Health — Book List — This list of books focuses on the multi-faceted connections between mental health and physical activity, nutrition, and sleep.
Poverty and Mental Health — Book List — Review these books on the multi-faceted connections between mental health and poverty for individuals and families domestically and abroad.
Mental Health as a Public Health Issue — Book List — These books examine mental health from a variety of broad public health perspectives, including populations health, social determinants of health, eliminating stigma, global perspectives, and social policy.
Reports, Resource Guides, and Action Plans — Learn how national and international organizations have used public health approaches to promote children’s mental health.
Evaluating What We Did, Why It Matters, and Where We're Going Next
Doctoral student Chelsea Hetherington recently wrote about her work evaluating the partnership CYFC has with Bruce Vento Elementary School to support student success at school, increasing access to healthy foods, and fostering a supportive school community. Read about the evaluation on the Healthy Bodies, Healthy Minds, Healthy Learners blog.
CYFC in the News
St. Paul Pioneer Press — St. Paul school garden grows vegetables and better police-community relations
Center for Family Development Announcements
New Website to Help Improve Access to Healthy Foods
Food shelves, food pantries, and other emergency food programs are an important part of healthy food access. Center for Family Development training, print materials, and videos are available free of charge to food shelf directors, volunteers, and others working to improve healthy food access.
The training, print materials, and videos on this section of this website are available free of charge to food shelf directors, volunteers, and anyone else working to improve healthy food access. Get these resources on the Building Better Food Shelves website.
University & Community Conferences, Training, and Resources
Mapping Social Emotional Learning in Youth Programs
Sponsor: University of Minnesota Extension Center for Youth Development
Date: October 25, 2016
Cost: $100 per organization (teams of 2 to 3)
Location: St. Paul, MN
Develop a deeper understanding of how your program offerings align with social and emotional skill building by “mapping” your own program. Participants will leave with tools to further social emotional learning (SEL) in their work, feedback from peers on your SEL map, and an action plan for next steps to further SEL. Learn more and register on the Center for Youth Development website. [no longer active]
Podcast Focuses on Understanding School Anxiety
Marti Erickson, Ph.D., founding director of CYFC, and her daughter, Erin Erickson, recently interviewed Jordan Hart, Ph.D., about how to help children and families dealing with school anxiety. Listen to the podcast on the MomEnough website.
Mental Health Conference Comes to St. Cloud
Sponsor: National Alliance on Mental Illness — St. Cloud (NAMI St. Cloud)
Date: October 7, 2016
Credits: 6 continuing education hours
Location: St. Cloud, MN
Learn from keynote speakers Sue Abderholden, B.A., M.P.H., and Ken Barlow, B.S. about the major developments in medication and treatment practices that have been developed over the 30 years existence of NAMI St. Cloud. Participants will learn why it is important to treat addictive behaviors and mental illness at the same time, the core features of Acceptance and Commitment Therapy, developments in bipolar disorder, and what it is like to live with mental illness and how it impacts the family. Learn more on the NAMI St. Cloud website.
Nature-Based Therapeutic Conference to Focus on Human-Animal Interactions
Sponsor: University of Minnesota Center for Spirituality & Healing and Minnesota Landscape Arboretum
Date: October 26, 2016
Location: Chaska, MN
The conference, “Speak! A Kinship of All Creatures: Broadening our Knowledge of Human-Animal Interactions,” will highlight the way our human partnership with animals and the natural world, including our positive interactions with animals, increase individual health and community well-being. Jonathan Balcombe, Ph.D., will share the latest information on animal emotional intelligence. Learn more on the Arboretum’s website.
‘Opportunity Conference: Advancing LGBTQ Health’ Registration Now Open
Sponsor: Rainbow Health Initiative
Date: February 27-28, 2017
Location: St. Paul, MN
Learn from keynote speakers and breakout sessions focusing on transgender youth, LGBTQ aging, and bisexual health during this conference. Participants will learn how to address health disparities based on emerging data, improve health outcomes, and promote policy, systems and environmental change. Learn more and register on the conference website.
Washburn Center for Children — Family-focused therapist [no longer active]