The Impacts of Trauma on Our Health Care System

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Young woman consoling a crying female friend while sitting on sofa

By Kelly Munson, President, Aetna Medicaid, a CVS Health Company

According to the CDC, a traumatic event is marked by a sense of horror, helplessness, serious injury, or the threat of serious injury or death. Sadly, 70 percent of adults will experience at least one traumatic event in their lifetime — the effects of which can linger far beyond the event itself.

Research shows that traumatic events can have an adverse effect on both our physical and mental health, especially when these events occur in childhood, commonly referred to as adverse childhood experiences (ACEs). According to the Center for Health Care Strategies, conditions linked to trauma exposure include chronic lung and heart diseases; liver disease, viral hepatitis and liver cancer; autoimmune diseases; sexually transmitted infections; and depression and other mental health conditions.

Given the long-lasting effects of trauma, and therefore long-lasting effects on our health care system, it’s imperative that we are well-informed and using the best approaches to understand and treat those who have experienced trauma in any form — be it directly or through their work with someone who has experienced trauma. As a result, our members, our employees and our communities will benefit. 

Addressing Trauma to Better Serve Vulnerable Populations  

While trauma can occur anywhere and to anyone, it is the unfortunate truth that the Medicaid population, often growing up in or navigating difficult environments and experiences, is more likely to have a history of ACEs and trauma. This greatly impacts Medicaid recipients’ physical and mental health — and makes them less likely to address these issues, particularly if their health care experience makes them feel as though they’ve had to relive their trauma in any way. 

This is where trauma-informed care comes into play. This shift in the delivery of care centers on making those who have experienced trauma — and we know this to be nearly three-quarters of those walking through the door — feel safe and comfortable receiving care. A major part of this shift is simply remembering the power and impact of your words and actions. Taking the treatment focus from “what’s wrong with you” to “what happened to you” centers care on a complete picture of the person to promote effective health care service and promote healing. 

Another core aspect of trauma-informed care is coordination between a member’s doctors. If each doctor is aware of the circumstances that are being treated, it allows them to proceed accordingly, without having the member repeat the story of their trauma each time they enter a doctor’s office —avoiding revictimization. While these changes might seem small, they have a significant impact on the experience for members because they feel seen and understood. In gaining a member’s trust and ensuring they are as comfortable as possible, they will be much more likely to address their issues head-on, improving outcomes for both provider and member. 

Addressing Secondary-Trauma to Better Serve Your Employees  

A major, and sometimes unnoticed, step towards helping those who are working to overcome trauma is ensuring that those responsible for overseeing this process are equipped to do so. Unfortunately, studies show that between 6 and 26 percent of therapists working with traumatized populations are at risk of what we call secondary trauma. Alongside a lower sense of wellbeing, this can also mean burnout and turnover within staff that is critical to helping a population in need. 

In an effort to help bridge this gap, Aetna recently launched the Trauma Informed Care Center of Excellence, aimed at addressing secondary trauma and the impact of ACEs on a person’s lifelong health. The center offers resources to communities including a learning collaborative, a manual to help organizations implement trauma informed care practices in their workplace and a lifeline to experts in the field for ongoing and sustained growth.

Through the Center, Aetna is also sponsoring a year-long investigation designed, conducted and evaluated by the University of Oklahoma’s Hope Research Center in partnership with Sunbeam Family Services in Oklahoma City and Hillsides in East Los Angeles County. While the science tells us that hope can mitigate the effects of secondary traumatic stress, our hypothesis is that a workforce with higher hope is more likely to experience better job satisfaction and overall wellness, as well as come to their jobs each day with renewed energy and focus for the benefit of their children and families. 

While there are long-established studies on the effects of trauma, the manner with which we approach and aid those who are or have experienced it, in any form, continues to develop each day. Given the pervasiveness of the issue at hand, it’s critical that we continue to learn, implement and treat our members and ourselves with the care we need to move forward with confidence and health on our side. 

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