Y Health
Y Health
What Are Counter-ACEs? with Dr. Ali Crandall
Episode Summary
Inspired by a 'glass half full' perspective, Dr. Ali Crandall researched the long-term health benefits of positive childhood experiences. In this episode, Crandall explains the known detrimental effects of ACEs (adverse childhood experiences), then discusses the implications of prioritizing “counter-ACEs” in children’s lives.
Guest Bio
BYU professor Dr. Ali Crandall focuses her research on family and mental health, executive functioning, and adolescent/child well-being. She earned a Bachelor of Science in Community Health Education (equivalent to the current "Public Health Promotion" degree) from Brigham Young University. Crandall went on to earn a Masters in Public Health from Loma Linda University and later a PhD in Public Health from Johns Hopkins University.
Episode Resources
- Research summary on counter-ACEs with Dr. Ali Crandall
- Published scientific journal research article on ACEs and counter-ACEs with Dr. Ali Crandall
- Belonging by Nora Krug
Recorded, Edited & Produced by Christy Gonzalez, Harper Xinyu Zhang, and Tanya Gale
Welcome to Y Health, a podcast brought to you I'm Dr. Cougar Hall, a professor here at Brigham Young University. Whether you are a student, a parent or a BYU fan, this podcast will help you navigate the world of public health. Our podcast strives to create an informative environment, helping individuals receive accurate information regarding public health. So whether it's global or local, we will discuss how it pertains to you. Just kick back and relax as we talk about why health. Hello, everyone. This morning, my guest is Dr. Ali Crandall. Ali, thank you for joining us today.
Ali Crandall :It's my pleasure, Cougar.
Cougar Hall :I want to allow you just an opportunity to Tell us in particular about your educational background, your career, how you wound up here as a faculty member in the Department of Public Health at BYU?
Ali Crandall :Sure. So I did my undergrad here in our It was not called public health, it was health sciences. And I studied community health education, which students today will know better as the health promotion emphasis. And after graduating there, I went to a school in Southern California called Loma Linda University. After that, I worked for a while, so I did that master's of Public Health in International Health, and so I did some international work at that time, particularly in Asia, in Vietnam. And I also worked for an international adoption agency going around the world to different countries Ethiopia, South America, Eastern Europe and and so on. And then I kind of felt like I was supposed to do something different. And I was felt like I was kind of nudged along to go on for a PhD and went to a school in Maryland called Johns Hopkins and studied public health there. And my focus there was I really was interested in families and how families affect our health and what we can do as a society and communities to help families be stronger in order to improve the health of individuals and communities. So that's kind of my journey eventually ended up here and love it.
Cougar Hall :Well, we love having you here, that's for You're a terrific colleague. You're your pathway here is really cool. How did international work both you know, travel but also work. How did it change your perspective?
Ali Crandall :I think one of the things is just seeing looking at the world. I think another thing that comes out is just the strengths and weaknesses between cultures and seeing. These are wonderful blessings I have being here in the United States, but there's also these wonderful blessings and attributes of other cultures and communities both across the United States, but also in other parts of the world. And just trying to be more cognizant of that and not saying, oh, we've we've got it all down. Like there's a lot of things that other countries have maybe a better figured out than us and some of their relationships with each other and, and so.
Cougar Hall :On. I love that. I really appreciate that. I, I've had similar experiences and I think what it's taught me is to approach life with greater humility and wanting to learn and take the best of everything I see and change myself and change what I can around me to. So now that leads us to a discussion about your your research. You have been researching families and family health. Will you just take a moment and share with our audience a little bit about what you've termed aces and then counter aces as well?
Ali Crandall :Absolutely. So this has been an area of some other faculty here in our department and community members as well. So aces are adverse childhood experiences and they include things like abuse and neglect. Things within the family could be divorce or death in the family. A family member who's experiencing mental illness, incarceration, substance abuse. Some of these things are very common and most Americans have at least one. And the reason this has become so important, it actually started a couple of decades ago with this research. They found that the more aces somebody had, even in adulthood, they had worse physical and mental health outcomes. And so they were long lasting. The impact, particularly if somebody had four or more aces than it was really troubling just how much, you know, you're going to see ten times higher rates of suicide and and other things coming from having four, four or more aces versus not having any aces. So it's it's quite profound. We were looking at this research and of course, we're always thinking, what can we do? And a lot of these. Acs, they occur in the family. So that's why being researchers are on the family. That is what kind of grabbed our eye. But we thought, you know, does everything have to be a glass half empty? What are the good things that can happen in childhood? Do they help to offset these ACS? Do they create just positive things in general? So in talking with some community partners, we turned them advantageous childhood experiences or counter aces.
Cougar Hall :What are the counter aces?
Ali Crandall :It's really relationships with family adults or neighbors. Your peers feeling like you belong in your community, feeling good about yourself, and then having structure and routines in your life. And every child needs stability, nurturing and structure in their life. And that's really what these counter ACS kind of get at is did you have these for year 18?
Cougar Hall :So let me ask a question, a personal from time to time is getting his teeth kicked in with parenting and trying to do my best and really trying to balance being strong and, you know, helping my children recognize that life is hard and there's going to be some some difficulty. But they can they can stand up and they can push through. They they're more resilient, more capable than they think. They are trying to balance that with, hey, I need to protect my children. Literally, the Lord sent them to my home and it's my stewardship to care for them and to provide a nurturing and a loving environment for them. So how do I balance those things? Preparing them for the real world, which is going to be challenging, but being a counter face for them and being a support and being a champion for them and helping them to reach all of the goals and expectations that they have for themselves as well.
Ali Crandall :Right. So we based this research on something different components to resiliency theory. But one of them is that challenge in a child's life is important and it actually helps us to thrive and grow and progress. And without that challenge, we'd be in in trouble, which is I mean, the Lord sent us here to Earth, right? For for this challenge. The difference, I think, between aces and just normal challenge is like abuse, for example. That's that's just never a good challenge for a child to experience. So we want to completely get rid of or eradicate abuse. Now, some other things like mental illness in the family. What we don't want is people start feeling guilty like I'm a depressed mom or dad. And so I've I'm sinking my child ship. Right. And that's that's an adversity. That's it's very common. It is associated with being an ace. But I think that's where the counter aces can come into play. Are we providing our children with this nurture and support? And at times when we feel at the end of the rope, like, we can't do it. Are you finding others that maybe can help? Because that's what comes out with the counter aces is there's a family component, but the family isn't enough. They need more than just the family. Our communities are so important to supporting us.
Cougar Hall :So it sounds like your research then is village, that there's some truth to that, that it really does take some support from others. Can we transition just a little bit then, from families to communities, maybe even to nations, maybe even to the world? So we're recording this in March of 2022. We're we're just over two years into a pandemic. Do ACS apply on a larger level? Do we feel that collectively in our communities, anything along those lines that you can talk about?
Ali Crandall :Yeah. So the research I've done has been mention here because I don't think I got to this, but the counter race is actually we're more predictive of health than the ACS were. So and in the opposite direction. So ACE is hurt health emotionally, particularly with the mental health, but also physical health. But counter ACS made improved health and help protect against mental illness. Now, during COVID, a lot more of us are experiencing depression and anxiety, and that's really coming out when an individual experience is ACS. The reason it's so impactful on their lifelong health is it's impacting them biologically and cognitively and and in different ways. So like a child, their brain is developing rapidly. And so when all this trauma occurs, it can impact even the structure and function of the brain, which may be a reason they may have grow up and not have maybe quite as much self control or have some connections in the brain that that make them more at risk for depression. Let's say societies can be that way, too. And I think sometimes we're quick to judge a country like what's the matter with them? Why don't they just work harder, pull themselves up by their bootstraps? Well, this trauma that they may have occurred over time can really impact even their ability to respond and what's going on. So a little bit more kindness and compassion from us as individuals and collective communities I think can go a long way.
Cougar Hall :You're speaking wisdom to me for sure. And this this idea being that there's a common humanity and that we need to be empathic towards others and seek first to to understand and suspend judgment. And I just think there are so many lessons there for us individually, within our families, within our communities. And that does feel like the counter to the divisiveness that for some reason has been an additional plague with COVID.
Ali Crandall :There's a lot of them and they're painful. Right. But if we can learn, hey, I don't have to be the judge that the savior is already has that role. And my role is just to love and to mourn with those that mourn that. That's the counter race right there. Let me understand their pain. I may not agree always. Like maybe I have a very different political perspective, but there's pain there that people are experiencing that I can I can have empathy for that and and be there, whether it's individually or let's help our country, our society to be there.
Cougar Hall :What's next for this field of study and maybe Because you've published a fair amount in ACS, what do you see as the next step? As scholars, we typically have a line at the end of a paper that we write, which is like future research should. So along those lines, what do you see next when it comes to ACS and counter ACS? How would you like to see this move forward?
Ali Crandall :Yeah, so something that we've started working What are the positive experiences that adults need? Because they're as adults, we're usually the ones that provide both the ACS and the counter ACS. And a lot of times we're so focused in our intervention, work on children, but we forget that the best way to support the child is to make sure that they have a healthy adults taking care of them. So our next thing is kind of exploring, well, what are those things that are positive and adult life? That can kind of be the counter race. But for the adult, even if they had high aces or low counter aces, what's there for them so that they're and all of us are in a better place to be supportive, compassionate people, ready to give children the things that they need and each other as academics.
Cougar Hall :We know a lot about a really small sliver of Is there something I should have asked that I haven't?
Ali Crandall :I don't know necessarily that you haven't the main things that have stood out to me from this research is the lack of counter ACS may actually be more devastating to a child. So if a parent isn't really responsive and a child doesn't have at least one parent that they can trust or have other adults and peers in their life that are good influence, that could be more harmful. And so thinking about what are we doing that way, just to make sure that the child has a variety of solid and safe relationships?
Cougar Hall :Can I ask a concluding question here? And you can go wherever direction you want. What gets you excited right now? Is there something you're reading, someone you're listening to? Is there is there a specific aspect of your research that just gets you out of bed in the morning and you're ready to rock and roll?
Ali Crandall :There's a lot of things that that get me out. But one of the things that I've been thinking about lately, I just read this book by Nora Krug, and I'm not sure if I'm saying her name right, but it's called Belonging. And I believe the subtitle is A Germans Reckoning with History and Family. And I've never been a graphic novel reader that hasn't been my genre, but this is a graphic novel. And what this author did, she's from Germany, was born after the Holocaust, and every time she traveled internationally, she'd have to really grapple with how people were responding to her being German and their memories and knowledge of of World War Two. And that was this collective identity that they shared in Germany. And so she went researching all her own family history and everything, trying to understand how her family had been involved in it and included all these documents in this book. But one of the things that I just have been really thinking about, especially as we're facing this war in Eastern Europe and other wars around the world, is in Germany. Maybe they were forced to reckon with what they had allowed to happen. And I wonder if we've been forced to reckon with what we've allowed to happen here in the United States with different wars or what's happened with Native American populations and slavery and and other horrific things that I think we can sometimes say. But that wasn't me. But it's still it's a collective identity and our ability to wrestle with that and acknowledge it happened, do what we can to make it right and accept the Savior's atoning grace, I think, will be remarkable in helping us move forward. But if we don't, we might continue. And this is across the world, not just the United States, to perpetuate more conflict and violence. And I think we can keep being that ace if we don't really reconcile with the aces that we've allowed to occur throughout our history.
Cougar Hall :Thank you so much. What a reminder to remain humble. I think we do have this knee jerk reaction to be defensive. Well, that's not my fault whether this is in our our families, our marriages at work or as we contextualize where we're at with history and with the events that have occurred. And so to remain humble and say, well, how do I become that counter base on an individual or a societal level?
Ali Crandall :If you figure it all out, Cougar, can you let Because I'm working at it.
Cougar Hall :But hey, there's a reason I'm asking the The smart people on the other side of the glass, that's you. So and you are as busy as they come. And I really appreciate your time and I wish you all the best. Thank you, Dr. Crandall.
Ali Crandall :Thanks for having me on, Cougar.
Cougar Hall :Anytime. Thank you for joining us today. Catch us on our next episode and don't forget to subscribe to Future Y Health episodes.
