At a time when it feels like polarization and division threaten to tear the very fabric of American society, it’s refreshing to see examples of how Americans in communities both progressive and conservative can still agree. I have been traveling the United States having powerful conversations about the impact of adversity and toxic stress on our children. From Florida to California and Wyoming to New York, folks from both sides of the aisle are recognizing the importance of trauma-informed care and doing right by our kids.

I recently visited Palm Beach County, Florida, where Renée Layman and her team at the Center for Child Counseling are leading a network of organizations who are doubling-down on the science of adversity and investing in the safety of our children. They deeply understand what I have specialized in treating for decades, first as a pediatrician in an underserved community in San Francisco, then as California’s first Surgeon General. The effects of Adverse Childhood Experiences including abuse, neglect, or parental mental health disorders have nothing to do with partisan politics. They pose a biological threat, literally putting children's lives at risk for the long term.

Since the landmark Adverse Childhood Experiences (ACE) Study, an overwhelming scientific consensus has demonstrated that cumulative adversity during critical developmental periods of a child’s life can lead to prolonged activation of the body’s biological stress response (a condition that’s now known as the toxic stress response). The toxic stress response can change the structure and function of children’s developing brains, hormonal systems and immune systems, leading to increased risk for physical and mental health problems throughout the lifetime.

Like one in six Americans, 42% of children surveyed at one of the Center’s partner schools in Palm Beach County have four or more ACEs. Without intervention, these children are twice as likely to develop heart disease or cancer, roughly four times as likely to have a teen pregnancy, and 30 times as likely to contemplate suicide as their classmate with no ACEs.

We know the cost of ACEs to society–from Palm Beach County to the Central Valley of California–is enormous. A CDC study published in 2023 associated ACEs with an annual economic burden of $14.1 trillion in the United States, and nearly $800 billion per year in Florida alone.

In 2019, Center for Child Counseling developed an ACEs-aware approach to ensure that kids in Palm Beach County get access to the evidence-based care they need without long wait-lists or delays.

Today, the Center employs evidence-based ACEs screening. Children with four or more ACEs are eligible to receive wraparound services, while those who are at lower risk can be directed to resources focused on education and early prevention. And of course, if a family needs more, they get more.

But the Center isn’t just delivering better care, they are creating a better system. Co-locating ACEs-aware services in primary care facilities, childcare centers, schools, and nonprofits, the Center works tirelessly with local organizations to provide multi-language support groups for parents, workshops for teachers and promotoras, access to legal aid, and online resources. They’re building community capacity to address the trauma at-risk children are experiencing early, and research shows that early intervention can actually prevent kids from tipping over into poor mental and physical health outcomes later. This is a model we can all learn from. Last year, the Center for Child Counseling trained more than 12,000 people in Florida and around the nation on the impact of ACEs and trauma.

In a moment when our nation is facing a youth mental health emergency, an ACEs-aware approach is not just essential, it can be life-saving. There is hopeful work happening, and what I saw in Florida reminded me that we must look for the helpers in times of overwhelming challenges. If we look up from our news alerts and towards our neighbors, we will find people working to better every corner of our world. We must shine a light on trusted organizations, invest in them, and support them.

Together we can create strong communities of care and prevent the trauma our children are experiencing now from metastasizing into serious and expensive health outcomes down the road. Our very future depends on it.

Dr. Nadine Burke Harris is a Pediatrician and California’s First Surgeon General and Renée E. Layman is the President and CEO of Center for Child Counseling.